HarlingenRecruiter Since 2001
the smart solution for Harlingen jobs

Care Manager II (RN) - Field/Remote

Company: Centene Corporation
Location: Mcallen
Posted on: November 23, 2019

Job Description:

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.

  • 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
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
  • 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
  • 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.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed
  • -Travel is required
    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 and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.

    Licenses/Certifications: Current state's RN license.

    Texas Requirements:
    Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.

    Licenses/Certifications: Current state's RN license is required and valid driver's license is required.
    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: Centene Corporation, Harlingen , Care Manager II (RN) - Field/Remote, Healthcare , Mcallen, Texas

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


Psychiatrist
Description: Position Summary br br Life in the Air Force can add unique pressures in addition to the normal stresses of daily life. Specializing in the diagnosis, treatment and prevention of mental health and (more...)
Company: U.S. Air Force
Location: Brownsville
Posted on: 12/13/2019

Emergency Services Physician
Description: Position Summary br br When Airmen or their families have a medical emergency, time can be of the essence. Focused on immediate decision-making and treatment, Emergency Services Physicians take the (more...)
Company: U.S. Air Force
Location: Brownsville
Posted on: 12/13/2019

Flight Surgeon
Description: Position Summary br br Pilots, aircrew and special duty operators are exposed to extreme environments in air, space and battle. As an Air Force Flight Surgeon, you will serve as the primary care physician (more...)
Company: U.S. Air Force
Location: Brownsville
Posted on: 12/13/2019


Travel Nurse RN - Dialysis - $1,646 per week
Description: NurseFly Travel Nursing with Stability Healthcare is seeking a dialysis travel nurse for a travel nursing job in Brownsville, Texas: br br br ul br li Specialty: Dialysis br li Discipline: (more...)
Company: NurseFly Travel Nursing
Location: Brownsville
Posted on: 12/13/2019

PCU/Stepdown RN Needed For A 13 Week Contract
Description: Skyline Med Staff is looking for some of the most talented nurses in the industry to fill
Company: Skyline Med Staff
Location: Brownsville
Posted on: 12/13/2019

Registered Nurse (RN) Neuroscience Stepdown Unit
Description: Description SHIFT: Days rotating weekends br br SCHEDULE: Full-time br br Do you want to be a part of a family and not just another employee Are you looking for a work environment where diversity (more...)
Company: Rio Grande Regional Hospital
Location: Mcallen
Posted on: 12/13/2019

Registered Nurse (RN) Progressive Care
Description: Description SHIFT: Nights rotating weekends br br SCHEDULE: Full-time br br Do you havethe career opportunities you want in your current role We have an excitingopportunity for you to join (more...)
Company: Rio Grande Regional Hospital
Location: Mcallen
Posted on: 12/13/2019

Registered Nurse (RN) Hemodialysis
Description: Registered Nurse RN Hemodialysis Description SHIFT: Nights rotating weekends SCHEDULE: Full-time Do you have the career opportunities you want in your current role We have an exciting opportunity (more...)
Company: HCA
Location: Brownsville
Posted on: 12/13/2019

Travel Nurse RN - Dialysis - $1,555 per week
Description: NurseFly Travel Nursing with trustaff featured is seeking a dialysis travel nurse for a travel nursing job in BROWNSVILLE, Texas: br br br ul br li Specialty: Dialysis br li Discipline: (more...)
Company: NurseFly
Location: Brownsville
Posted on: 12/13/2019

Family Physician
Description: Position Summary br br The world-class healthcare the Air Force provides isn't just for our Airmen, it's also for their families. Family Physicians are responsible for the comprehensive care in men (more...)
Company: U.S. Air Force
Location: Brownsville
Posted on: 12/13/2019

Log In or Create An Account

Get the latest Texas jobs by following @recnetTX on Twitter!

Harlingen RSS job feeds