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Senior Care Manager, RN – STAR/CHIP
Centene Corporation. Assess, plan, and implement complex care management activities to enable quality, cost-effective healthcare outcomes .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management activities, including personalized care planning, clinical assessment, and member outreach. Proficient in regulatory compliance and effective communication with healthcare providers and families to ensure quality, cost-effective healthcare outcomes.
Highest-signal resume keywords
Registered Nurse - RNClinical AssessmentCare ManagementPatient EducationRegulatory Compliance
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 PlanningClinical DocumentationProblem-SolvingService CoordinationMember Outreach
Soft Skills
Attention to DetailOrganizationTime ManagementCommunicationFlexibility
Certifications & Qualifications
State LicensureCompact State Licensure
Industry Keywords
MedicaidSTAR CHIPPerson-Centered CareAdult PopulationCare Transitions
About the role
Key responsibilities & impact- Assess, plan, and implement complex care management activities to enable quality, cost-effective healthcare outcomes
- Develop personalized care plans/service plans for care members
- Address member issues and educate members and families/caregivers on services and benefit options
- Continuously assess care plans and collaborate with providers, specialists, and community resources
- Coordinate between members/families/caregivers and care provider teams to ensure appropriate person-centered care
- Monitor member status, changes in condition, and progress toward care plan goals; revise plans as needed
- Identify problems and barriers and recommend care management interventions for escalated cases
- Review member data, referrals, and intake assessments to improve quality and develop appropriate care plans
- Perform telephonic, digital, home, and/or other site outreach to assess member needs
- Collaborate with healthcare providers to facilitate services/treatments and revise care plans
- Collect, document, and maintain member information and care management activities for regulatory compliance
- Provide or facilitate education on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits
- Partner with leadership to improve care and quality delivery cost-effectively
- May precept clinical new hires and provide coaching, shadowing, onboarding, and competency support
- Engage with People Leaders and cross-functional teams to measure and monitor new-hire readiness
- Perform other assigned duties and comply with all policies and standards
Requirements
What you’ll need- Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing
- 4–6 years of related experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required
- 7+ years of clinical nursing RN experience with direct patient care, clinical assessment, person-centered care planning, member outreach, care transitions, access to care, family & patient education, and ongoing service coordination preferred
- Experience primarily with the adult population, serving members ages 0–65
- Strong clinical documentation, problem-solving, communication, attention to detail, organization/time management skills
- Ability to work under quick TAT times and deadlines
- Ability to adapt to changing business needs with openness, flexibility, and professionalism
- Knowledge and experience working with state-government sponsored programs (Medicaid, STAR CHIP) is a plus
- Availability for Monday through Friday, 8:00 a.m. to 5:00 p.m. CST
Benefits
Comp & perks- 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
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity