Care Manager I (RN)-Quad Cities, IL

Company: Illinois Health Plan
Location: Hull
Posted on: March 17, 2023

Job Description:

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.THIS POSITION IS REMOTE/WORK FROM HOME WITH APPROXIMATELY 10% TRAVEL IN THE QUAD CITIES OF IL; DAVENPORT, MOLINE AND ROCK ISLAND.

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 careDevelop, 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
10% travel to perform home visits to members -with mileage reimbursement at the current IRS guideline rate.Education/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.Valid driver's license and proof of car insurance.For Illinois Youth Care contract: Required Education/Experience - Bachelor's Degree in nursing and RN licensure required. One year of clinical experience required.Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.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.

Keywords: Illinois Health Plan, Columbia , Care Manager I (RN)-Quad Cities, IL, Executive , Hull, Missouri