What are the responsibilities and job description for the Care Manager position at Fidelis Care - New Jersey?
Transform the lives of 28 million members as part of Centene, a national organization dedicated to improving community health. Enjoy competitive benefits and flexible work arrangements.
Must reside in Bergen and/or Passaic County to provide home visits within these regions. Up to 75% travel required.
Job Purpose:
Develop personalized care plans for physically challenged members, focusing on high-quality, cost-effective healthcare outcomes through education and collaboration with caregivers and healthcare providers.
- Evaluate member needs, barriers to care, and social determinants of health, prioritizing identified goals and recommending optimal plans for successful outcomes.
- Establish ongoing care plans, identifying necessary resources, specialists, and community services to address unmet needs.
- Identify and address care barriers through targeted interventions.
- Coordinate between members, caregivers, and healthcare teams to ensure person-centered care services.
- Ongoing monitoring of member status and progress toward care plans.
- Collaborate with members, caregivers, and healthcare providers to revise or update care plans as needed to meet member goals and unmet needs.
- Provide resource support for employment, housing, independent living, justice, foster care, and other services based on service assessments and plans.
- Facilitate care management and collaborate with healthcare providers to ensure timely access to necessary care or services.
- Conduct telephonic, digital, home, and/or site outreach to assess member needs and collaborate with resources.
- Maintain accurate records of member information and care management activities to ensure compliance with regulatory requirements.
- Provide education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits.
- Offer feedback to leadership on opportunities to improve and enhance care delivery for members in a cost-effective manner.
Requirements:
Bachelor's degree in Nursing or equivalent, along with 2–4 years of related experience. RN – Registered Nurse licensure is mandatory.
Benefits:
Centene offers a comprehensive package including competitive pay, health insurance, 401K, stock purchase plans, tuition reimbursement, paid time off, and flexible work arrangements. Total compensation may include additional incentives based on individual qualifications.
Diversity and Inclusion:
Centene is an equal opportunity employer committed to diversity and values individual differences. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics.
