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Acute Care RN Care Manager – ED, Med, Surg, ICU
Centene Corporation. Assess and coordinate medical and supporting services across the continuum of care for complex/high-acuity populations .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in developing personalized care plans and coordinating medical services for high-acuity populations, while ensuring compliance with clinical guidelines and enhancing quality of care. Proficient in conducting in-home assessments and collaborating with multidisciplinary teams to advocate for member needs.
Highest-signal resume keywords
Registered Nurse - State LicensurePatient Care ExperienceCare Plan DevelopmentIn-Home AssessmentsResource Utilization Group Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care CoordinationClinical AssessmentPatient AdvocacyService AuthorizationQuality ImprovementData ReviewDisease EducationCare ManagementComplications MonitoringTreatment Facilitation
Soft Skills
CollaborationCommunicationCoachingProblem-SolvingInterpersonal Skills
Certifications & Qualifications
Texas RN LicenseCompact State RN LicenseResource Utilization Group Certification
Industry Keywords
Acute CareHigh-Acuity PopulationsLong-Term CareClinical GuidelinesEmergency Room ExperienceMultispecialty ICU ExperienceMed/Surg ExperienceCardiac ExperienceTelemetry ExperienceHome Visits
About the role
Key responsibilities & impact- Assess and coordinate medical and supporting services across the continuum of care for complex/high-acuity populations
- Develop personalized care plans/service plans for long-term care members
- Evaluate service needs and recommend plans for high-risk/high-acuity members
- Continuously assess care plans and collaborate with care management teams, providers, specialists, and community resources
- Coordinate between members/families/caregivers and care provider teams
- Monitor member status, complications, clinical symptoms, changes in condition, and progress toward care goals
- Review member data, referrals, and intake assessments to improve quality and operating performance
- Facilitate member services, treatments, revised care plans, and service authorizations
- Collect, document, and maintain member information and care management activities
- Educate members and families/caregivers on disease processes, care gaps, provider instructions, care options, referrals, benefits, and community resources
- Act as liaison and member advocate between members/families, physicians, and facilities/agencies
- Perform home and other site visits as required
- Partner with leadership to improve quality of care and cost-effective service delivery
- May precept and coach clinical new hires, support onboarding, and assess competency readiness
- Perform other duties as assigned and comply with policies and standards
Requirements
What you’ll need- 6+ years of direct patient care experience with adults, children, or adolescents in the acute care/hospital setting
- Emergency Room, Multispecialty ICU, Med/Surg, Cardiac, OR/Prep-Op, or Telemetry experience preferred
- Must have a Texas RN license and/or Compact State RN license
- Graduate from an Accredited School of Nursing or a Bachelor's degree and 4–6 years of related experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required, or NP - Nurse Practitioner - Current State's Nurse Licensure required
- Resource Utilization Group (RUG) certification must be obtained within 90 days of hire
- Travel for member visits is required
- Ability to perform in-home assessments and member visits around Southwest Houston, TX
- Compliance with state, federal, and clinical guidelines
Benefits
Comp & perks- Mileage reimbursement for weekly travel
- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules