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Care Manager I RN

Company: Oklahoma Complete Health
Location: Lawton
Posted on: February 10, 2024

Job Description:

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
*Must reside in Oklahoma and within one of five Child Welfare Services regions. This role will require home visits*Oklahoma Complete Health, a Centene company, is committed to providing quality healthcare solutions to transform the health of Oklahomans.
At Oklahoma Complete Health, we are community advocates and change-makers in search of an inclusive culture grounded by our commitment to work-life balance, competitive compensation, and continuous career development. Join us and be a part of a collaborative, growing network of innovative thinkers delivering solutions at the local level.Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care

  • Develop, assess and adjust, as necessary, the care plan and promote desired outcome
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
  • Provide patient and provider education
  • Facilitate member access to community based services
  • Monitor referrals made to community based organizations, medical care and other services to support the members' overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systemsEducation/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.

    Licenses/Certifications: Current state's RN license.For Oklahoma Complete Health Only: Registered nurse with a license to practice in the State of Oklahoma. Must successfully complete the Behavioral Health Case Manager certification training provided through the Department of Mental Health and Substance Abuse Services within (6) months of date of hire.For Oklahoma Complete Health - Children's Specialty Program Preferred Experience: Instate presence with knowledge of the complex care needs of the population served, particularly children adjudicated, deprived and in custody of the state child welfare or juvenile justice system through formal education, personal, or employment experience. Experience also includes assisting with facility transition, adolescent to adulthood transition, provider terminations, and changes in level of care (BH inpatient to residential care/group home LOC)Pay Range: $52,900.00 - $95,200.00 per year
    Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
    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. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Keywords: Oklahoma Complete Health, Lawton , Care Manager I RN, Executive , Lawton, Oklahoma

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