Care Manager RN

Position Overview

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. In this role, you will develop, assess, and facilitate complex care management activities for members with primarily physical needs, ensuring high-quality, cost-effective healthcare outcomes through personalized care plans and education for members and their families. This position is open to candidates located in Macomb and Wayne County, Michigan, and requires 75% travel for member visits.

Key Responsibilities

• Evaluate members' needs, barriers to care, and social determinants of health, recommending and facilitating optimal care plans.
• Develop ongoing care/service plans and collaborate with providers and community resources to address unmet needs.
• Identify problems or barriers to care and provide appropriate care management interventions.
• Coordinate between members, families/caregivers, and care provider teams to ensure person-centered care.
• Provide ongoing follow-up, monitoring changes in condition, and adjust care/service plans in collaboration with all stakeholders.
• Offer resource support regarding local services (e.g., employment, housing, justice) based on assessments and plans.
• Facilitate timely access to required care or services through collaboration with specialists and providers.
• Conduct outreach through various modalities (telephonic, digital, home, or other sites) to assess member needs.
• Document all member information and care management activities to ensure regulatory compliance.
• Educate members and families/caregivers on disease processes, addressing care gaps, provider instructions, care options, referrals, and healthcare benefits.
• Provide feedback to leadership on opportunities to improve care and quality delivery in a cost-effective manner.
• Perform other duties and comply with all policies, standards, and leadership directives as assigned.

Required Qualifications

• Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing with 2–4 years of related experience.
• RN – Registered Nurse with State Licensure and/or Compact State Licensure required.

Benefits & Perks

• Competitive pay with actual pay adjusted based on skills, experience, and education.
• Health insurance options available.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• A flexible approach to work with remote, hybrid, field, or office work schedules.

Centene is an equal opportunity employer committed to diversity and inclusion. 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 any other protected characteristic. Qualified applicants with arrest or conviction records will be considered in accordance with applicable local and state regulations.