Case Manager Position Available In Duval, Florida

Job Description:

You could be the one who changes everything for our 28 millionmembers. Centene is transforming the health of our communities, oneperson at a time. As a diversified, national organization, you’llhave access to competitive benefits including a fresh perspectiveon workplace flexibility. Must reside in Manatee County for face toface field visits with members.

Position Purpose:

Develops,assesses, and facilitates complex care management activities forprimarily physical needs members to provide high quality,cost-effective healthcare outcomes including personalized careplans and education for members and their families. Must reside inManatee County for face to face field visits with members.

• Evaluates the needs of the member, barriers to accessing theappropriate care, social determinants of health needs, focusing onwhat the member identifies as priority and recommends and/orfacilitates the plan for the best outcome
• Develops ongoing careplans / service plans and collaborates with providers to identifyproviders, specialists, and/or community resources to addressmember’s unmet needs
• Identifies problems/barriers to care andprovide appropriate care management interventions
• Coordinates asappropriate between the member and/or family/caregivers and thecare provider team to ensure members are receiving adequate andappropriate person-centered care or services
• Provides ongoingfollow up and monitoring of member status, change in condition, andprogress towards care plan / service plan goals; collaborate withmember, caregivers, and appropriate providers to revise or updatecare plan / service plan as necessary to meet the member’s goals /unmet needs
• Provides resource support to members and caremanagers for local resources for various services (e.g.,employment, housing, participant direction, independent living,justice, foster care) based on service assessment and plans, asappropriate
• Facilitate care management and collaborate withappropriate providers or specialists to ensure member has timelyaccess to needed care or services
• May perform telephonic,digital, home and/or other site outreach to assess member needs andcollaborate with resources
• Collects, documents, and maintains allmember information and care management activities to ensurecompliance with current state, federal, and third-party payerregulators
• Provides and/or facilitates education to members andtheir families/caregivers on disease processes, resolving caregaps, healthcare provider instructions, care options, referrals,and healthcare benefits
• Provides feedback to leadership onopportunities to improve and enhance care and quality delivery formembers in a cost-effective manner
• Other duties orresponsibilities as assigned by people leader to meet businessneeds
• Performs other duties as assigned.
• Complies with allpolicies and standards.

Must reside in Manatee County for face toface field visits with members.

Education/Experience:

Requires aDegree from an Accredited School of Nursing or a Bachelor’s degreein Nursing and 2

• 4 years of related experience.

License/Certification:

• RN•Registered Nurse•State Licensureand/or Compact State Licensure required•For Sunshine Health (FL)

Only:

Employees supporting Florida’s Children’s Medical Services(CMS) must have a minimum of two years of pediatric experience. Mayrequire up to 80% local travel required Must reside in ManateeCounty for face to face field visits with members.

Pay Range:

$55,100.00

• $99,000.

00 per year Centene offers a comprehensivebenefits package including: competitive pay, health insurance, 401Kand stock purchase plans, tuition reimbursement, paid time off plusholidays, and a flexible approach to work with remote, hybrid,field or office work schedules. Actual pay will be adjusted basedon an individual’s skills, experience, education, and otherjob-related factors permitted by law, including full-time orpart-time status. Total compensation may also include additionalforms of incentives. Benefits may be subject to programeligibility. Centene is an equal opportunity employer that iscommitted to diversity, and values the ways in which we aredifferent. All qualified applicants will receive consideration foremployment without regard to race, color, religion, sex, sexualorientation, gender identity, national origin, disability, veteranstatus, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will beconsidered in accordance with the LA County Ordinance and theCalifornia Fair Chance Act