RN Care Manager - OB

Centene Corporation•Remote-MO, MO

7d•Remote

About The Position

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high-quality, cost-effective healthcare outcomes, including personalized care plans and education for members and their families. This role provides education and support to pregnant members. Applicants may work remotely from home anywhere within Missouri. The schedule is Monday through Friday, 8 a.m. to 5 p.m.

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.

Responsibilities

Evaluate member needs and barriers to appropriate care, assess social determinants of health, prioritize concerns identified by members, and recommend or facilitate plans for the best outcomes.
Develop ongoing care or service plans and collaborate with providers to identify providers, specialists, and community resources to address unmet needs.
Identify problems and barriers to care and provide appropriate care management interventions.
Coordinate between 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, including employment, housing, participant direction, independent living, justice, and foster care, as appropriate to service assessments 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, as needed.
Collect, document, and maintain member information and care management activities to ensure compliance with state, federal, and third-party payer regulations.
Provide or facilitate education for members and their families or caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits.
Provide feedback to leadership on opportunities to improve care and quality delivery for members in a cost-effective manner.
Perform other duties or responsibilities as assigned to meet business needs and comply with all policies and standards.