Care Manager Transition of Care
| Company | Centene |
|---|---|
| Location | Washington, USA, Georgia, USA, Arizona, USA, Mississippi, USA, Tennessee, USA, Northeastern United States, USA, Oklahoma, USA |
| Salary | $55100 – $99000 |
| Type | Full-Time |
| Degrees | Master’s |
| Experience Level | Junior, Mid Level |
Requirements
- Requires a Master’s degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.
- LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN required.
Responsibilities
- Evaluates the needs of the member by completing post discharge assessments for members transitioning from healthcare facilities.
- Evaluates medication and performs reconciliation between pre-admit and post-discharge medications.
- Develops a care/service plan and collaborates with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs.
- Assesses member current health status, resource needs, services, and treatment plans and provides appropriate interventions.
- Facilitates the transition into active care management based on member needs.
- Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve member overall quality of care.
- Facilitates services between Primary Care Physician (PCP), specialists, medical providers, and non-medical resources as necessary to meet the medical and socio economic needs of members.
- May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources.
- Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulations.
- Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
- Other duties or responsibilities as assigned by people leader to meet business needs.
- Performs other duties as assigned.
- Complies with all policies and standards.
Preferred Qualifications
- Advanced proficiency in Excel, including the ability to create and manage complex spreadsheets.
- Active RN license (compact license).
- Residence in one of the following states preferred: Georgia (GA), Tennessee (TN), Nebraska (NE), Oklahoma (OK), or Washington (WA).
- Located in Central (CST) or Pacific (PST) time zones.