TempleRecruiter Since 2001
the smart solution for Temple jobs

Care Manager II (RN) - Field/Remote - Brownsville,TX

Company: Centene Corporation
Location: Temple
Posted on: November 6, 2019

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.

  • 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
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • 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
  • 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.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed
  • Travel is required
    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 and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.

    Licenses/Certifications: Current state's RN license.

    Texas Requirements:
    Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.

    Licenses/Certifications: Current state's RN license.

    Superior Health Plan: Candidates with active RN license in good standing and requires 2+ years' of clinical RN experience in pediatrics or obstetrics' in clinical acute care, community, or managed care settings, and 1+ year experience in care management

    Licenses/Certifications: Current state's RN license required and valid driver's license is required. -


    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: Centene Corporation, Temple , Care Manager II (RN) - Field/Remote - Brownsville,TX, Executive , Temple, Texas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Executive Jobs


Regional Vice President
Description: Company in the Marketing sector. ul li Providing leadership to our team of client success directors and managers li Developing
Company: Verticurl
Location: Round Rock
Posted on: 11/15/2019

Design Director
Description: About the Job Purpose of Job We are currently seeking a talented Director, Design for the San Antonio Home Office I or the Austin Design Studio. At USAA, Design Directors manage and inspire their team (more...)
Company: USAA
Location: Austin
Posted on: 11/15/2019

Intermediate Care Unit Manager, Nurse
Description: Description SHIFT: No Weekends br br SCHEDULE: Full-time br br St. David's South Austin Medical Center is part of St. David's HealthCare , one of the largest health systems in Texas, which was (more...)
Company: St. David's South Austin Medical Center
Location: Austin
Posted on: 11/15/2019


Market Manager - Clinical Professional Development
Description: We Are Hiring br br Market Manager - Clinical Professional Development br br Austin, TX br br Are you looking for an opportunity to take your leadership skills and Clinical Education experience (more...)
Company: Ascension, C59
Location: Austin
Posted on: 11/15/2019

Pharmacy Operations Manager
Description: Description SHIFT: Days rotating weekends br br SCHEDULE: Full-time br br With more than 119 sites across Central Texas, St. David---sHealthCare includes seven of the area---s leading hospitals (more...)
Company: St. David's Medical Center
Location: Austin
Posted on: 11/15/2019

Project Manager
Description: RESPONSIBILITIES:Kforce has a client that is seeking a Project Manager in Austin, Texas TX Responsibilities: Responsible for the delivery of infrastructure and deliver the result through all stages (more...)
Company: Kforce Technology Staffing
Location: Austin
Posted on: 11/15/2019

Care Manager I (RN)
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 (more...)
Company: Centene Corporation
Location: Hutto
Posted on: 11/15/2019

eCommerce Content Management Advisor, Business Operations (Round Rock / Austin, TX)
Description: eCommerce Content Management Advisor, Business Operations Austin / Round Rock, TX Dell provides the technology that transforms the way we all work and live. And we are more than a technology company (more...)
Company: Dell (UK)
Location: Austin
Posted on: 11/15/2019

Director -Actuarial Data Scientist
Description: Director of Actuarial Data Scientist Austin, Tx br We are looking to add a Life Health Actuary with data science experience to our team. This role will be responsible for building actuarial and predictive (more...)
Company: The HT Group
Location: Austin
Posted on: 11/15/2019

Senior Vice President, Medical Management
Description: Position Purpose: Oversee and coordinate the medical management, vendor delegation oversight, provider performance and key accounts relations. Support the company's strategic plan, establish the strategic (more...)
Company: Centene Corporation
Location: Manor
Posted on: 11/15/2019

Log In or Create An Account

Get the latest Texas jobs by following @recnetTX on Twitter!

Temple RSS job feeds