护理经理 转院（注册护士）
Care Manager Transition of Care (RN)
职位职责：执行护理管理职责，评估、计划并协调出院后成员在医疗和辅助服务方面的各项事宜，促进高质量且成本有效的护理。完成入院前的药物审查和出院后的药物核对。与护理管理和协调团队合作，识别过渡期支持服务。
关键信息：候选人必须拥有加利福尼亚州的有效注册护士执照。优先考虑居住在加利福尼亚州且能够按照太平洋时间（PST）工作的候选人。具有病例管理、过渡期护理、护理协调和出院计划经验者优先。
- 通过完成从医疗机构出院的成员评估，评估成员的需求
- 评估药物并进行入院前和出院后药物的核对
- 制定护理/服务计划，并与出院规划师、提供者、专科医生和跨学科团队合作，以支持成员的过渡和出院需求
- 评估成员当前健康状况、资源需求、服务和治疗方案，并提供适当的干预措施
- 根据成员需求，协助其进入主动护理管理阶段
- 为成员、授权的照顾者和提供者提供或协助提供教育和资源材料，以促进健康活动，提高成员的整体护理质量
- 在必要时在初级保健医生（PCP）、专科医生、医疗提供者和非医疗资源之间协调服务，以满足成员的医疗和社会经济需求
- 可能会通过电话、数字、家庭和其他现场访问来评估成员需求并与相关资源协作
- 收集、记录并维护所有成员信息和护理管理活动，以确保符合当前州、联邦和第三方支付方的法规要求
- 向领导层提供反馈，提出改进和提升成员护理和质量交付的机会，同时保持成本效益
- 其他由上级分配的职责以满足业务需求
- 执行其他指派的任务
- 遵守所有政策和标准
教育/经验：需要行为健康或社会工作硕士学历，或护理学院认证学位，并具有2至4年相关经验。
执照/认证
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Position Purpose: 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.
Key Details: Candidates must possess an active RN license in the state of California. Preference will be given to candidates who reside in California and are able to work Pacific Time (PST) hours. Experience in case management, transitional care, care coordination, and discharge planning is strongly preferred.
- 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
Education/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 2 – 4 years of related experience.
License/Certification:
· LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN required
Pay Range: $27.02 - $48.55 per hour
At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Originally posted on Himalayas