Senior Care Manager Transition of Care

Company: WellCare of North Carolina
Location: Raleigh
Posted on: November 15, 2024

Job Description:

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.

Must reside in North Carolina.

Position Purpose: Assesses, plans and implements all aspects of medical and supporting services across the continuum of care for post-discharge members, promoting quality, cost effective care. Completes pre-admission and post-discharge medication reconciliation. Works with the care management and coordination teams to identify complex care transition support services.

• Evaluates the needs of the member by completing clinical 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 transition into care management service for member based on acuity level
• Provides or facilitates education and resource materials to members, authorized caregivers, and providers to promote wellness activities to improve overall member 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
• Serves as a subject matter expert to staff for clinical and non-clinical questions or issues related to post hospital outreach for members
• May precept new hires and support building core skills and providing guidance through the onboarding process
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides feedback to leadership on opportunities to improve and enhance care and quality of delivery for members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standardsEducation/Experience: Requires a Master's degree in Behavioral Health or Social Work or a Degree from an Accredited School of Nursing and 4 - 6 years of related experience.
  
  License/Certification:
  
  • LISW, LCSW, LMSW, LMFT, LMHC, LPC, or RN
  • requiredPay Range: $72,400.00 - $130,100.00 per year
    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. Total compensation may also include additional forms of incentives.
    
    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

Keywords: WellCare of North Carolina, Greenville , Senior Care Manager Transition of Care, Executive , Raleigh, North Carolina