RN
Company: Sunshine State Health Plan
Location: West Palm Beach
Posted on: September 25, 2024
Job Description:
You could be the one who changes everything for our 28 million
members. Centene is transforming the health of our communities, one
person at a time. As a diversified, national organization, you'll
have access to competitive benefits including a fresh perspective
on workplace flexibility.
This is a remote/work-from-home opportunity with local travel
required for member visits. Candidates should reside in Baker,
Nassau, Duval, Clay, St. Johns, Flagler, or Volusia Counties in
Florida to be considered for this role. Preference given to those
in Duval or Nassau County. 2 years of pediatric experience is
required. Position Purpose: Develops, assesses, and facilitates
complex care management activities for primarily physical needs
members to provide high quality, cost-effective healthcare outcomes
including personalized care plans and education for members and
their families.
- Evaluates the needs of the member, barriers to accessing the
appropriate care, social determinants of health needs, focusing on
what the member identifies as priority and recommends and/or
facilitates the plan for the best outcome
- Develops ongoing care plans / service plans and collaborates
with providers to identify providers, specialists, and/or community
resources to address member's unmet needs
- Identifies problems/barriers to care and provide appropriate
care management interventions
- Coordinates as appropriate between the member and/or
family/caregivers and the care provider team to ensure members are
receiving adequate and appropriate person-centered care or
services
- Provides ongoing follow up and monitoring of member status,
change in condition, and progress towards care plan / service plan
goals; collaborate with member, caregivers, and appropriate
providers to revise or update care plan / service plan as necessary
to meet the member's goals / unmet needs
- Provides resource support to members and care managers for
local resources for various services (e.g., employment, housing,
participant direction, independent living, justice, foster care)
based on service assessment and plans, as appropriate
- Facilitate care management and collaborate with appropriate
providers or specialists to ensure member has timely access to
needed care or services
- 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 regulators
- Provides and/or facilitates education to members and their
families/caregivers on disease processes, resolving care gaps,
healthcare provider instructions, care options, referrals, and
healthcare benefits
- 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 standardsEducation/Experience:
Requires a Degree from an Accredited School of Nursing or a
Bachelor's degree in Nursing and 2 - 4 years of related
experience.
License/Certification:
- RN - Registered Nurse - State Licensure and/or Compact State
Licensure required
- For Sunshine Health (FL) Only: Employees supporting Florida's
Children's Medical Services (CMS) must have a minimum of two years
of pediatric experience. May require up to 80% local travel.Pay
Range: $54,000.00 - $97,100.00 per yearCentene 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.
Keywords: Sunshine State Health Plan, Boca Raton , RN, Other , West Palm Beach, Florida
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