[Hiring] Care Manager Transition of Care @Centene Corporation

Role Description

Performs care management duties to assess, plan and coordinate aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality and cost effective care.

• Completes medication review for pre-admission and post-discharge reconciliation.
• Works with the care management and coordination teams to identify transition support services.
• Evaluates the needs of the member by completing post discharge assessments for members transitioning from healthcare facilities.
• Evaluates medication and performs reconciliation between pre-admit and post-discharge medications.
• Develops a care/service plan and collaborates with discharge planners, providers, specialists, and interdisciplinary teams to support member transition and discharge needs.
• Assesses member current health status, resource needs, services, and treatment plans and provides appropriate interventions.
• Facilitates the transition into active care management based on member needs.
• Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve member overall quality of care.
• Facilitates services between Primary Care Physician (PCP), specialists, medical providers, and non-medical resources as necessary to meet the medical and socio-economic needs of members.
• May perform 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 regulations.
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
• Other duties or responsibilities as assigned by people leader to meet business needs.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing.
• 2 – 4 years of related experience.

Requirements

• LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN 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.