4658 registered nurse ii jobs found

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care Assist in...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. NOTE: This is a remote work-from-home role for Michigan or Illinois applicants with one of the following active independent licenses: RN, LPN, LPC (MI), LCPC (IL), LCSW, LMSW. This role provides case management / care coordination services to children and adults with high acuity behavioral health and medical complexities (often dual diagnoses). Applicants with strong clinical documentation skills preferred. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. NOTE: This is a remote telephonic role for Illinois-based applicants. Preference for applicants with licensure: LPN, RN, LCSW (for Illinois state). This role offers case management services for members of all ages receiving Medicaid. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *** PLEASE NOTE: Candidate must reside in either of those zip codes: 60653, 60615, 60637, 60649, 60619, 60617, 60628, 60827, 60633, 60616 *** Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. * Coordination and care management of members with lower utilization of home community services (i.e. members attending adult day care services or those who are stable on current medication / treatment regimens). * Manages an active caseload based on state mandated ratios according to residential setting, case intensity...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Provides Case Management services to a specific clientele. Systematically identify and addresses fragmentation of care, and fill gaps in are using proactive initiatives. Assesses medical records for appropriateness, level of care provided and criteria determination. Identifies appropriate care for patients by evaluating high-risk cases, intensity and complexity of services, health care costs and non-compliance issues. Coordinates care between multiple providers. Develops care plans in coordination with providers, patients, families as appropriate and assess the effectiveness. Organizes and schedules training for all new Case Management employees. May conduct periodic quality assurance...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Seeking a Program Specialist II in Miami-Dade County, FL . Field/Remote position. Will conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. ** Applicants for this position have the flexibility to work remotely from their home anywhere within the Central time zone ** • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *REMOTE; must work PST hours* Position Purpose: The Utilization Review Nurse II leads the daily activities of the Utilization Management RN I positions. Participates with the manager in the selection process for open UM RN positions. Conducts routine audits of the UM RN I job duties and oversees workload balancing. Provides first level clinical review for outpatient and ancillary services requiring authorization. Utilizes decision-making and critical-thinking skills in the review and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls, managing them in a professional and competent manner. Processes all prior authorizations to...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. *REMOTE in NY* Position Purpose: The Case Manager/Care Coordinator II is responsible for the coordination of services and cost effective management of health care resources to meet individual members’ health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members and HN to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant clinical judgment, independent analysis, critical-thinking, detailed knowledge of departmental procedures, clinical guidelines, community resources, contracting and community standards of care. Case...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Conduct screening and risk assessment interventions per program guidelines. Act as primary liaison for members and staff. Assist with aspects of the member’s care, including referrals to community resources. • Identify special needs members through the completion of health screens and other resources • Work with community outreach/member advocates to coordinate member care • Educate providers and community resources on program components and available support services • Educate members with special needs to foster compliance with program and positively impact outcomes • Conduct site visits as appropriate for programs and provide support to other special programs • Develop and modify...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This position is 50% field based in the Peoria area in Illinois. Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered without gaps...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This position is 50% field based covering the Rockford area in Illinois. Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Responsible for members gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, care plan development, assessment, and care coordination. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care Assist in...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: The Case Manager/Care Coordinator II is responsible for the coordination of services and cost effective management of health care resources to meet individual members’ health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members and HN to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant clinical judgment, independent analysis, critical-thinking, detailed knowledge of departmental procedures, clinical guidelines, community resources, contracting and community standards of care. Case Management...

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: The Case Manager/Care Coordinator II is responsible for the coordination of services and cost effective management of health care resources to meet individual members’ health care needs and promote positive health outcomes. Acts as a member advocate and a liaison between providers, members and HN to seamlessly integrate complex services. Case Management services are generally focused on members who fall into one or more high risk or high cost groups and require significant clinical judgment, independent analysis, critical-thinking, detailed knowledge of departmental procedures, clinical guidelines, community resources, contracting and community standards of care. Case Management...