Care Manager (RN)

Centene Corporation • Remote-NJ, NJ

21h • $56,200 - $101,000 • Remote

About The Position

Develops, assesses, and facilitates complex care management activities for members with primarily physical needs to support high-quality, cost-effective healthcare outcomes. This includes creating personalized care plans and providing education to members and their families. The role evaluates member needs, barriers to appropriate care, and social determinants of health, prioritizing the needs identified by the member and facilitating plans to achieve the best outcomes.

This is a remote position requiring up to 50% local travel for in-home member visits throughout the assigned territory. Candidates must hold an active New Jersey Registered Nurse (RN) license. Bergen and Passaic Counties are the primary coverage area, and candidates residing in either county are strongly preferred. The typical schedule is Monday through Friday, 8:00 a.m. to 5:00 p.m. ET, with flexibility based on member and business needs.

Requirements

• Degree from an accredited school of nursing or a Bachelor’s degree in Nursing.
• 2–4 years of related experience.
• Active RN state licensure or compact state licensure; candidates must hold an active New Jersey RN license.
• Ability to travel locally for in-home member visits, up to 50% of the time.

Nice To Haves

• Residence in Bergen or Passaic County, the primary coverage area.

Responsibilities

• Evaluate member needs and barriers to accessing appropriate care, including social determinants of health, and recommend or facilitate plans based on the member’s priorities.
• Develop ongoing care plans or service plans and collaborate with providers to identify specialists and community resources to 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 support adequate, appropriate, person-centered care or services.
• Follow up on 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 regarding local services, including employment, housing, participant direction, independent living, justice, and foster care resources, as appropriate.
• Facilitate care management and collaborate with providers or specialists to 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 ensure compliance with applicable state, federal, and third-party payer regulations.
• Provide or facilitate education for members and families or caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits.
• Provide leadership with feedback on opportunities to improve care and quality delivery cost-effectively.
• Perform other duties as assigned and comply with all policies and standards.

Benefits

• Competitive pay
• Health insurance
• 401(k)
• Stock purchase plans
• Tuition reimbursement
• Paid time off and holidays
• Flexible approach to remote, hybrid, field, or office work schedules
• Additional forms of incentives may be included in total compensation, subject to applicable factors and eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level