RN Care Manager I, Pediatrics, Bonus Eligible
Company: Sunshine State Health Plan
Posted on: January 15, 2022
You could be the one who changes everything for our 25 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, multi-national organization,
you'll have access to competitive benefits including a fresh
perspective on workplace flexibility
This position is bonus eligible!
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
Develop, assess and adjust, as necessary, the care plan and promote
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
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
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 systems
For LTSS - 30% travel to perform home visits to members
Department: Children's Medical Services CMS - (Enhanced Care
Coordination / Med Fragile Team)
Caseload: Pediatrics - Newborn to 21-year olds receiving private
duty nursing services.
Caseload based on residence.
Territory: Miami-Dade County (Hialeah, Miami Gardens, Miami,
Palmetto Bay area).
Work-from-home case management role with temporarily suspended home
visits due to COVID-19.
Field/Local travel typically within county.
Must reside in or be willing to relocate to the above mentioned
area of Florida.
Travel will be 30% once we resume member home visits.
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work
schedules and dress flexibility
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and
Education/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.
Valid driver's license and proof of car insurance.
For Sunshine Health (FL) Only: Employees supporting Florida's
Children's Medical Services (CMS) must have a minimum of two years
of pediatric experience.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. 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
other characteristic protected by applicable law.
Keywords: Sunshine State Health Plan, Miami , RN Care Manager I, Pediatrics, Bonus Eligible, Executive , Miami, Florida
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