- Develop, assess and adjust, as necessary, the care plan and promote desired outcome
- 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 needs
- 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
- Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
- For LTSS - 30% travel to perform home visits to members
- For New Hampshire, Massachusetts, & Michigan Complete Health - home visits required
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Manager, Care Coordination
1 week ago
TriWest Healthcare Alliance Phoenix, United States**Profile**: · Veterans, Reservists, Guardsmen and military family members are encouraged to apply · We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TX, UT, VA/DC, *WA, WI & WY only) · **Job ...
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Care Center Manager
1 week ago
Secure Transportation Company Inc Phoenix, United States**Summary Description** · The Care Center Manager is responsible for the execution of various call center strategies which is · inclusive of meeting all service level standards for the lines of business supported within the Care Center. In addition, this role must conduct regular ...
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Customer Care Manager
2 weeks ago
Raymond Handling Solutions Phoenix, United States**Raymond West** is looking for a sharp **Customer Care Manager **to join the team Our Customer Care Manager will be responsible for the managing and directing aftermarket activities at assigned Major, National and Key Customer Accounts. Primary focus being Customer Retention, Pr ...
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Customer Care Manager
2 weeks ago
Handling Systems Inc Phoenix, United StatesRaymond West is looking for a sharp Customer Care Manager to join the team Our Customer Care Manager will be responsible for the managing and directing aftermarket activities at assigned Major, National and Key Customer Accounts. Primary focus being Customer Retention, Program Im ...
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Managed Care Resource
3 days ago
Ensign Services Phoenix, United States**About the Company** · **About the Opportunity** · The Managed Care Consultant supports the Skilled Nursing Facility leaders in managed care contracting and revenue enhancement strategies for all healthcare payers and preparation for changes in the healthcare industry. · - This ...
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Care Management Associate
1 week ago
NTT DATA Phoenix, United StatesNTT DATA Corporation is a top 10 global services company and part of the NTT Group, a Fortune 29 telecommunications and services company based in Japan. We operate with 60,000 professionals in 36 countries. Every day around the world we help clients explore new ways to respond to ...
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Care Manager Extender Pool
1 week ago
Valleywise Health System Phoenix, United StatesThis position provides clerical support to ensure patients achieve a smooth and timely transition from an acute care facility or in the outpatient setting to help prevent readmissions. This position assists with setting up outpatient services or providing resources to help the pa ...
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Care Management Resource Coordinator
3 weeks ago
Phoenix Children's Hospital Phoenix, United StatesThe Care Management Resource Coordinator supports the efforts of Social Work, Case Management and Utilization Management professionals by performing a wide range of administrative duties that promote a positive patient-family experience during hospitalization, facilitate safe and ...
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Care Manager-behavioral Health
1 week ago
Blue Cross Blue Shield of Arizona Phoenix, United StatesAwarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses a ...
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Home Care Acquisitions Manager
1 week ago
A Place For Mom Phoenix, United States**Company Description** About A Place for Mom** · We're the leading online platform connecting families searching for senior care with a team of experienced local advisors providing insight-driven, personalized solutions. As the nation's most trusted senior advisory service, we a ...
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Home Care Branch Manager
2 weeks ago
Endeavor Home Care Group, LLC Phoenix, United States**We are truly passionate about helping others and are looking for someone to join our family at Endeavor as a Branch Manager for our Scottsdale/Phoenix Office.** · Endeavor Home Care is one of the largest and fastest growing privately owned, Non-Medical Home Care Agencies in Ari ...
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Home Care/personal Care Agency Manager
5 days ago
PROACTIVE HOME CARE Phoenix, United StatesProactive Home Care is looking for a compassionate and dedicated Operational Manager. The Operational Manager will be responsible for managing the day-to-day Home Care business activities. Overseeing all personnel Human Resources Department. Under the direction of the Chief Execu ...
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Social Work Care Manager
3 days ago
VillageMD Phoenix, United StatesAt VillageMD, we're looking for a **Social Work Care Manager** to help us transform the way primary care is delivered and how patients are served. As a national leader on the forefront of healthcare, we've partnered with many of today's best primary care physicians. We're equippi ...
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Pediatric Integrated Care Manager
2 days ago
Blue Cross Blue Shield of Arizona Phoenix, United StatesAwarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses a ...
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Care Management Customer Support
2 days ago
NTT Data Services, Inc. Phoenix, United States**Care Management Support Rep** · - This is a Call Center Position. · - Will go onsite first day to pick up equipment. · - Monday to Friday 8am to 5pm. Training will be virtual 8am to 5pm for 3 weeks · - Coordinates care with providers as a part of comprehensive and proactive dis ...
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Manager - Clinical Care Coordination - Altcs
2 weeks ago
UnitedHealthcare Phoenix, United StatesAt UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more resp ...
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Manager, Client Care Ii
3 days ago
City National Bank Phoenix, United StatesOverview: · **MANAGER, CLIENT CARE II** · **WHAT IS THE OPPORTUNITY?** · Responsible for the day to day supervision of the bank's Client Contact Center which responds to a broad range of operational and technical support issues from clients of all banking offices/departments rega ...
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Practice Manager Primary Care Saguaro
1 week ago
HonorHealth Phoenix, United StatesOverview: · - **up to $10,000 Sign-On Bonus**: · - ** Monday - Friday; 5am to 5pm**: · - ** Located at N. Tatum Blvd & E. Union Hills Rd** · Looking to be part of something more meaningful? At HonorHealth, you'll be part of a team, creating a multi-dimensional care experience for ...
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Arizona Healthcare Phoenix, United StatesJob Description · Adult System of Care Clinical Program Manager · 525917 · PHOENIX · REMOTE OPTIONS · AHCCCS · Full-time · AHCCCS · Arizona Health Care Cost Containment System · Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork · The ...
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Banner Health Phoenix, United States**Primary City/State**: · Phoenix, Arizona · **Department Name**: · Case Mgmt-Hosp · **Work Shift**: · Day · **Job Category**: · Clinical Care · Our Care Coordination staff is seeking a part time RN Case Manager to work closely with patients and their families, physicians, and ot ...
Care Manager I - Phoenix, United States - Centene Corporation
Description
You could be the one who changes everything for our 28 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.
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.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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.