What are the responsibilities and job description for the Care Manager RN - Health Services Coordinator position at Superior HealthPlan?
Transform the lives of millions by delivering exceptional healthcare services. At Superior HealthPlan, we're dedicated to providing quality care for our members.
Job Summary
We're seeking a highly skilled Care Manager RN to join our team. As a Care Manager RN, you'll play a vital role in assessing and coordinating medical and supportive services for complex/high acuity populations. Your expertise will help develop personalized care plans, address issues, and educate members and their families on available services and benefits.
Key Responsibilities
- Evaluate member needs and recommend optimal care plans for best outcomes.
- Develop and continuously assess ongoing long-term care plans, collaborating with the care management team to identify necessary providers, specialists, and community resources.
- Coordinate between members, family/caregivers, and the care provider team to ensure adequate and person-centered care or services.
- Monitor care plans and member status, revising or updating plans as needed to meet goals/needs.
- Identify trends in member data to improve operating performance and quality care, adhering to state and federal regulations.
- Collaborate with healthcare providers to facilitate member services and treatments, determining revised care plans if necessary.
- Maintain accurate records of member information and care management activities, ensuring compliance with current state, federal, and clinical guidelines.
Required Skills and Qualifications
We're looking for candidates with a Graduate degree from an Accredited School of Nursing or a Bachelor's degree, along with 4-6 years of related experience. A Bachelor's degree in Nursing is preferred.
RN - Registered Nurse State Licensure or NP - Nurse Practitioner Current State's Nurse Licensure are required. Resource Utilization Group (RUG) certification must be obtained within 90 days of hire for Superior: Resource Utilization Group.
Benefits
Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules.
