行为健康、产科护士 - 护理经理
Behavioral Health, Maternity RN - Care Manager
你可能是为我们的2800万会员带来改变的人。Centene 正在逐人改善社区的健康状况。作为一家多元化、全国性的组织，你将享受到具有竞争力的福利，包括对工作灵活性的新视角。
****注意：这是一个完全远程的职位，负责为有行为健康状况的孕产妇和产后成员提供服务。优先考虑以下人员：(1) 持有有效的伊利诺伊州注册护士（RN）执照，(2) 具有高风险孕产和行为健康/物质滥用的综合专业经验，以及(3) 虚拟服务协调、个案管理、社区倡导经验。(4) 西班牙语流利者优先。
附加信息：
• 业务线：伊利诺伊州健康计划
• 部门：MED-医疗管理（个案管理）
• 工作时间：周一至周五，中央时间上午8点至下午5点
• 管理成员：行为健康的孕产妇成员。****
职位目的：为以身体需求为主的会员制定、评估和开展复杂的护理管理活动，以提供高质量、成本效益高的医疗结果，包括为会员及其家庭制定个性化护理计划和教育。
- 评估会员的需求、获取适当护理的障碍、健康需求的社会决定因素，重点关注会员所识别的优先事项，并推荐和/或协助制定最佳结果的计划
- 制定持续的护理计划/服务计划，并与提供者合作，确定提供者、专家和/或社区资源，以解决会员未满足的需求
- 识别护理中的问题/障碍，并提供适当的护理管理干预措施
- 在会员和/或家庭/照顾者与护理提供者团队之间进行适当的协调，以确保会员获得充分且适当的以个人为中心的护理或服务
- 提供对会员状况的持续跟进和监控，病情变化以及护理计划/服务计划目标的进展；与会员、照顾者和适当的提供者合作，根据需要修订或更新护理计划/服务计划，以满足会员的目标/未满足的需求
- 为会员和护理管理人员提供本地资源支持，以获取各种服务（例如就业、住房、参与者指导、独立生活、司法、寄养）的资源，根据服务评估和计划适当提供
- 协调护理管理
查看英文原文
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.
****NOTE: This is a fully remote role with serving maternity and postnatal members with behavioral health conditions. Preference will be given to individuals who (1) possess an active Illinois registered nurse (RN) license, (2) have a combination of professional experience with high-risk maternity and behavioral health/substance use, as well as (3) virtual service coordination, case management, community advocacy. (4) Spanish language fluency is a plus.
Additional Details:
• Line of Business: Illinois Health Plan
• Department: MED-Medical Management (Case Management)
• Schedule: Monday through Friday, 8 AM to 5 PM Central
• Caseload: behavioral health maternity members. ****
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 standards.
Education/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 YouthCare Illinois plan only: Bachelor’s Degree and IL RN licensure required. Must reside in IL
- 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 required
Pay Range: $55,100.00 - $99,000.00 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, 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