Long Term Care Nurse Specialist - Bronx, United States - Fidelis Care

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    Full time
    Description

    You could be the one who changes everything for our 26 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.

    Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination.Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development
    Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact
    Authorize and coordinate referral for services
    Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care
    Assist in coordinating the development of informal or voluntary services to integrate into the member care plan
    Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services
    Assist member with filing and resolving complaints and appeals
    Direct care to participating network providers
    Participate in care management committees and work on special projects related to care management as needed

    Education/Experience: 3+ years of care management experience preferred, Home health, discharge planning, or long term care experience preferred.

    Licenses/Certifications: Valid driver's license. NYS RN license required.

    The salary range for NY is: $ per hour

    This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

    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 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.