Care Manager I (RN)- Pediatrics
Company: Meridian Illinois
Location: Crystal Lake
Posted on: April 8, 2021
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Job Description:
Position Purpose: Perform care management duties to assess, plan
and coordinate all aspects of medical and supporting services
across the continuum of care for select members to promote quality,
cost effective care* Develop, assess and adjust, as necessary, the
care plan and promote desired outcome* Assess the member's current
health status, resource utilization, past and present treatment
plan and services, prognosis, short and long term goals, treatment
and provider options* Coordinate services between Primary Care
Physician (PCP), specialists, medical providers, and non-medical
staff as necessary to meet the complete medical socio economic
needs of clients* Develop plan of care based upon assessment with
specific objectives, goals and interventions designed to meet
member's needs* Provide patient and provider education* Facilitate
member access to community based services* Monitor referrals made
to community based organizations, medical care and other services
to support the members' overall care management plan* Actively
participate in integrated team care management rounds* Identify
related risk management quality concerns and report these scenarios
to the appropriate resources* Enter and maintain assessments,
authorizations, and pertinent clinical information into various
medical management systems* For LTSS - 30% travel to perform home
visits to members* For New Hampshire, Massachusetts, & Michigan
Complete Health - home visits requiredEducation/Experience:
Graduate from an Accredited School of Nursing. Bachelor's degree in
Nursing preferred. 2+ years of clinical nursing experience in a
clinical, acute care, or community setting. Knowledge of healthcare
and managed care preferred.Licenses/Certifications: Current state's
RN license. For New Hampshire and Massachusetts: Candidates with RN
license in good standing in other states than NH, must obtain a NH
RN within 90 days of hire. Active driver's license in good standing
preferred. For Arizona Complete Health - Complete Care Plan:
Obstetrics (OB) assignments requires RN experience in OB (clinical,
acute care, community) Pediatric assignments require RN experience
in pediatrics (clinical, acute care, community)For Michigan
Complete Health: Licensed RN; licensed nurse practitioner, licensed
physician's assistant. Valid driver's license required.LTSS
Requirements:Valid driver's license and proof of car insurance.For
North Carolina only: Care Managers, this individual shall be
responsible for conducting all functions and activities of the care
management program and serve as the lead for each care management
teams.--- Must reside in North Carolina--- Must be licensed
practitioners--- Must be supervised by an RN, LCSW, or psychologist
with trauma-based experience and training. --- Note: Care Manager
for medical services is a NC - Licensed Registered Nurse in good
standing. Care Manager for BH services in NC - Licensed LCSW in
good standing.Behavioral Health (BH) Managers and Full-Time BH
Staff: These individuals shall be responsible for integrating into
the clinical and care management teams to ensure Member's
behavioral health needs are fully integrated into the service
delivery system.--- Must reside in North Carolina--- Experience
working in behavioral health managed care and clinical setting---
Licensed behavioral health professional practicing within their
scopeCentene 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.
Keywords: Meridian Illinois, Crystal Lake , Care Manager I (RN)- Pediatrics, Healthcare , Crystal Lake, Illinois
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