Centene Management Company LLC is hiring a Pediatric Care Manager (RN) to join our mission of transforming community health. In this role, you will develop, assess, and facilitate complex care management activities for members with primarily physical needs, creating personalized plans and focusing on high-quality outcomes.
What You'll Do
- Evaluate member needs, barriers to care, and social determinants of health, focusing on member-identified priorities to recommend outcome plans.
- Develop ongoing care plans and collaborate with providers to identify specialists and community resources for unmet needs.
- Identify problems or barriers to care and implement appropriate management interventions.
- Coordinate between members, families, caregivers, and the care provider team to ensure adequate, person-centered services.
- Conduct ongoing follow-up to monitor member status and progress toward goals, updating care plans as necessary.
- Provide resource support for local services like employment, housing, and independent living based on assessments.
- Facilitate care management and collaborate with providers to ensure timely access to needed care.
- Perform telephonic, digital, home, or site outreach to assess needs and collaborate with resources.
- Collect, document, and maintain all member information and activities for regulatory compliance.
- Provide or facilitate education to members and families on disease processes, care gaps, provider instructions, and benefits.
- Provide feedback to leadership on opportunities to improve care delivery in a cost-effective manner.
- Perform other duties as assigned in compliance with all policies and standards.
What We're Looking For
- Degree from an accredited school of nursing or a Bachelor's degree in Nursing.
- 2 – 4 years of related experience.
- RN - Registered Nurse state licensure and/or compact state licensure.
- Two (2) years minimum of pediatric nursing experience.
- FL nursing licensure is required.
- Candidates must reside in Volusia County, Florida to be considered.
- For Sunshine Health (FL): Minimum of two years of pediatric experience.
- For YouthCare Illinois plan: Bachelor’s Degree and IL RN licensure. Must reside in IL.
Benefits & Compensation
- Compensation: $55,100.00 - $99,000.00 per year.
- Health insurance.
- 401K and stock purchase plans.
- Tuition reimbursement.
- Paid time off plus holidays.
- Flexible approach to work with remote, hybrid, field, or office schedules.
Work Mode
This is a hybrid position based in Volusia County, Florida.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
