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Care Manager
6 days ago
Caring Senior Service Dallas, United States**Make a career choice that makes a difference in the lives of seniors, become a homecare champion** · We are a non-medical, in-home caregiver agency that is dedicated to those we serve and to our team who makes it all happen. Our services include personal care assistance, meal p ...
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Field Care Manager
5 days ago
Caring Senior Service Dallas, United States**Make a career choice that makes a difference in the lives of seniors, become a homecare champion** · We are a non-medical, in-home caregiver agency that is dedicated to those we serve and to our team who makes it all happen. Our services include personal care assistance, meal p ...
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Value Based Care Compliance Manager
1 week ago
Conifer Revenue Cycle Solutions Dallas, United States**JOB SUMMARY** · The Compliance Manager contributes to Conifer Health's (Conifer) purpose by providing both strategic and day-to-day leadership to the compliance program designed to ensure Conifer fully complies with its Standards of Conduct and all applicable laws and regulatio ...
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Care Manager RN
1 week ago
Baylor Scott & White Health Rowlett, United States Full timeAbout Us · At Baylor Scott & White Health, we promote well-being for everyone. It's the largest nonprofit healthcare system in Texas, empowering a healthy lifestyle. · Our Core Values are: · We serve faithfully by doing what's right with a joyful heart. · We never settle by const ...
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Care Manager RN
2 days ago
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Supv, Care Management
3 weeks ago
Molina Healthcare Dallas, United StatesJob Description · JOB DESCRIPTION · Job Summary · Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long ...
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Pastoral Care Manager
3 weeks ago
Methodist Health System Dallas, United StatesHours of Work : · 40 · Days Of Week : · M-F · Work Shift : · 8X5 Day (United States of America) · Job Description : · Your Job: · The Manager Chaplaincy Services manage the services of the Pastoral Care Department at an assigned Methodist Health System campus ensuring the highest ...
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Employee Care Manager
3 weeks ago
Your Tailor Made Senior Service Dallas, United States Full timeTHE OPPORTUNITY · We're searching for an Employee Care Manager to join our Management team to recruit, hire, train and manage our field employees. You will provide leadership to a vast team of employees who provide care to seniors aging in place. · WHAT WE'RE LOOKING FOR · The Em ...
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Patient Care Manager
2 weeks ago
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Patient Care Manager
2 weeks ago
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Patient Care Manager
1 week ago
Three Oaks Hospice Dallas, United StatesAt · Three Oaks Hospice · we make a steadfast promise to our patients to · Listen , · Care · and · Serve · as a trusted partner devoted to providing the highest-quality hospice and palliative care and to serve with compassion bringing peace during this season of life. · WH ...
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Customer Care Manager
2 weeks ago
MasteryPrep Dallas, United StatesJob Description · Job DescriptionElevate Educational Experiences with Exceptional ServiceAt MasteryPrep, we blend customer service excellence with educational technology to profoundly impact student success. As our Customer Care Manager, you will lead the charge in providing seam ...
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Customer Care Manager
1 week ago
Likewize Dallas, United StatesJob Description: · Likewize is searching for a Customer Care Manager to join our team at our global Headquarters in Southlake, TX. · Your day-to-day responsibilities include but are not limited to: · Deliver excellent internal and external customer satisfaction by demonstratin ...
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Customer Care Manager
1 week ago
Uniphore Technologies Inc. Dallas, United States**Customer Care Manager** · Dallas, Texas / Pegasus Pegasus / Full-time Uniphore is the global leader in Conversational Service Automation. The Companys vision is to disrupt an outdated customer service model by bridging the gap between human and machine using voice, AI and auto ...
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Customer Care Manager
1 week ago
MasteryPrep Dallas, United StatesElevate Educational Experiences With Exceptional Service · At MasteryPrep, we blend customer service excellence with educational technology to profoundly impact student success. As our Customer Care Manager, you will lead the charge in providing seamless and supportive interacti ...
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Customer Care Manager
1 week ago
Remote Worker LTD. Dallas, United States1 week ago · Be among the first 25 applicants · Job Description · Job Description · Elevate Educational Experiences With Exceptional Service · At MasteryPrep, we blend customer service excellence with educational technology to profoundly impact student success. As our Custome ...
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Customer Care Manager
1 week ago
Remote Worker LTD. Dallas, United States1 week ago · Be among the first 25 applicants · Job Description · Job Description · Elevate Educational Experiences With Exceptional Service · At MasteryPrep, we blend customer service excellence with educational technology to profoundly impact student success. As our Custom ...
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Customer Care Manager
1 week ago
M/I Homes Dallas, United StatesM/I Homes has been building new homes of outstanding quality and superior design for more than 40 years. Founded in 1976 by Irving and Melvin Schottenstein and guided by Irving's drive to always "treat the customer right," we have fulfilled the dreams of over 140,000 homeowners a ...
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Customer Care Manager
1 week ago
M/I Homes Dallas, United StatesM/I Homes has been building new homes of outstanding quality and superior design for more than 40 years. Founded in 1976 by Irving and Melvin Schottenstein and guided by Irvings drive to always treat the customer right, we have fulfilled the dreams of over 140,000 homeowners and ...
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Complex Care Behavioral Health Care Manager
2 weeks ago
Knewin Dallas, United StatesYou 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. ...
Senior Care Manager - Dallas, 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.
Position is Remote but candidate must reside in the Central Time Zone
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 knowledge, experience 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 outcomesCoordinate 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
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
Case load will reflect heavier weighting of complex cases than Care Manager II, commensurate with experience
Serve as a subject matter expert for questions or issues for other Utilization Review and Care Managers, Referral Specialists and Program Coordinators
Audit case reviews to ensure compliance with case management policies and procedures and NCQA requirements
Assist with the development of case management workflows, policies, and procedures
Provide oversight to and assist with training of other case management staff
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 3+ 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. URAC Recognized Care Management Certification must be obtained within 6 months of hire.
For Shared Services:
Clinical licensure for multiple states is required
Pay Range:
$67, $121,300.00 per year 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.
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