Compensation and Benefits Manager managing compensation programs, research, and employee training at IQVIA. Responsible for evaluating programs and making recommendations for improvement.
About the role
- Senior Care Manager RN at Centene assessing and implementing complex care management activities and developing personalized care plans for healthcare outcomes. The role includes educating members and managing care services with approximately 75% travel.
Responsibilities
- Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes
- Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care
- Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialist, and/or community resources needed to address member's unmet needs
- Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care of services
- Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
- May identify problems/barriers for care management and appropriate care management interventions for escalated cases
- Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
- Performs 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 regulators
- Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
Requirements
- Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing and 4 – 6 years of related experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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