RN, Utilization Review – Care Manager
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $56,200 - $101,000 per year
About the role
- Develops, assesses, and facilitates complex care management activities for primarily physical needs members
- Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs
- Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
- Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals
- Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
Requirements
- Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing
- 2 – 4 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
care managementcare plansservice plansmember assessmentdocumentationmonitoringevaluationsocial determinants of health
Soft Skills
collaborationcommunicationproblem-solvinginterpersonal skills
Certifications
Registered NurseState LicensureCompact State Licensure