Care Manager (RN)

Centene Corporation•Remote-NJ, NJ

9d•$56,200 - $101,000•Remote

About The Position

The Care Manager (RN) develops, assesses, and facilitates complex care management activities for members with primarily physical needs. The role focuses on achieving high-quality, cost-effective healthcare outcomes through personalized care plans and education for members and their families. This is a remote position requiring an active New Jersey RN license and up to 50% local travel for in-home member visits. Candidates should reside in Bergen or Essex County, which are the primary coverage territories. The typical schedule is Monday through Friday, 8:00 AM to 5:00 PM EST, with flexibility based on member and business needs. The Care Manager evaluates member needs and barriers to appropriate care, considers social determinants of health and member-identified priorities, and recommends or facilitates plans to achieve the best outcomes. The role develops and updates ongoing care or service plans; coordinates with members, families, caregivers, providers, specialists, and community resources; monitors member status and progress; documents care management activities; and provides education and resource support. The Care Manager also identifies opportunities to improve care quality and cost-effective delivery. Centene describes its work as connecting people to care and supporting healthier lives. It offers a comprehensive benefits package, subject to program eligibility. Pay is adjusted based on individual qualifications and other job-related factors, and total compensation may include incentives.

Requirements

Degree from an accredited School of Nursing or a Bachelor's degree in Nursing.
2–4 years of related experience.
Registered Nurse (RN) state licensure and/or compact state licensure required; an active New Jersey RN license is required for this position.
Candidates should reside in Bergen or Essex County, New Jersey.
Ability to travel locally for in-home member visits, up to 50%.

Responsibilities

Evaluate member needs, barriers to accessing appropriate care, and social determinants of health, focusing on priorities identified by the member; recommend or facilitate a plan for the best outcome.
Develop ongoing care plans or service plans and collaborate with providers to identify providers, specialists, and community resources that can address unmet needs.
Identify problems and barriers to care and provide appropriate care management interventions.
Coordinate among members, families or caregivers, and care provider teams to help ensure members receive adequate, appropriate, person-centered care or services.
Follow up and monitor member status, changes in condition, and progress toward care plan or service plan goals; collaborate with members, caregivers, and providers to revise plans as needed.
Provide resource support to members and care managers for local services and resources, including employment, housing, participant direction, independent living, justice, and foster care, as appropriate to assessment and plans.
Facilitate care management and collaborate with providers or specialists to help ensure timely access to needed care or services.
Conduct telephonic, digital, home, or other site outreach to assess member needs and collaborate with resources.
Collect, document, and maintain member information and care management activities to support compliance with state, federal, and third-party payer regulators.
Provide or facilitate education for members and their families or caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits.
Provide feedback to leadership on opportunities to improve and enhance care and quality delivery in a cost-effective manner.
Perform other duties or responsibilities as assigned to meet business needs and comply with policies and standards.