Top 561 Health Net Jobs

Senior Care Manager (RN)
Meridian Michigan —Michigan
- $75,300 - $135,400 a year
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
9d
Utilization Review Clinician - Behavioral Health
Centene —Oregon
- $27.02 - $48.55 an hour
- Weekends as needed
- Remote
- LMFT
- Nursing
- Addiction Medicine
- Paid holidays
- Health insurance
4d
Care Manager (RN)
Centene Corporation —Michigan
- Full-time
- Remote
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
9d
Senior Compliance Investigator
Centene —New York, NY
- $70,100 - $126,200 a year
- Full-time
- Remote
- Writing skills
- High school diploma or GED
- Fair chance
- Paid holidays
- Health insurance
Inpatient Utilization Review Clinician, Behavioral Health
Centene —Louisiana
- $27.02 - $48.55 an hour
- Full-time
- Remote
- LMFT
- Nursing
- Addiction Medicine
- Paid holidays
- Health insurance
10d
Plan President & CEO - Health Net of California
Centene —Woodland Hills, CA
- $390,000 - $740,000 a year
- Full-time
- 5 years
- Master's degree
- Bachelor's degree
- Paid holidays
- Health insurance
8d
Remote Medical Director, Appeals
Centene —Washington, DC
- $236,500 - $449,300 a year
- Weekends as needed
- Remote
- Medicine
- Fair chance
- Senior level
- Paid holidays
- Health insurance
Corporate Ethics & Compliance Investigator
Centene —New York, NY
- $107,700 - $199,300 a year
- Full-time
- Remote
- 7 years
- Management
- HIPAA
- Paid holidays
- Health insurance
SIU Investigator
Centene —Florida
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- 1 year
- Paid holidays
- Health insurance
Associate Actuary - Medicaid
Centene —Washington, DC
- $87,700 - $157,800 a year
- Full-time
- Remote
- Research
- Mid-level
- Analysis skills
- Paid holidays
- Health insurance
Senior Compliance Administrator, Medicare Claims & Payment Integrity
Centene —Illinois
- $87,700 - $157,800 a year
- Full-time
- Remote
- Master's degree
- Presentation skills
- Bachelor's degree
- Paid holidays
- Health insurance
Senior Director, Migration & Integrations
Centene —Missouri
- $185,700 - $352,500 a year
- Full-time
- Remote
- 5 years
- Bachelor's degree
- US work authorization
- Paid holidays
- Health insurance
Medical Director
Absolute Total Care —South Carolina
- $225,700 - $428,900 a year
- Weekends as needed
- Remote
- Medicine
- BC/BE
- Fair chance
- Paid holidays
- Health insurance
Data Analyst IV Healthcare Analytics, Medical Economics
Centene —Michigan
- $87,700 - $157,800 a year
- Full-time
- Remote
- 3 years
- Finance
- Master's degree
- Paid holidays
- Health insurance
Senior Actuarial Analyst
Centene —Oregon
- $70,100 - $126,200 a year
- Full-time
- Remote
- Mid-level
- SQL
- Math
- Paid holidays
- Health insurance
8d
Manager, Payment Integrity- Readmission
Centene —Missouri
- $87,700 - $157,800 a year
- Full-time
- Remote
- Nursing
- RN License
- 3 years
- Paid holidays
- Health insurance
Senior Business Technical Analyst
Centene —Missouri
- $87,700 - $157,800 a year
- Full-time
- Remote
- Computer Science
- Research
- Master's degree
- Paid holidays
- Health insurance
6d
Utilization Review Clinician - ABA
Centene —Michigan
- $27.02 - $48.55 an hour
- Full-time
- Remote
- LMFT
- Nursing
- RN License
- Paid holidays
- Health insurance
1d
Supervisor, Utilization Management (RN)
Centene —Missouri
- $75,300 - $135,400 a year
- Full-time
- Nursing
- RN License
- Mid-level
- Paid holidays
- Health insurance
SIU Investigator
Centene —Michigan
- $56,200 - $101,000 a year
- Full-time
- Remote
- Mid-level
- Fair chance
- Associate's degree
- Paid holidays
- Health insurance

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Senior Care Manager (RN)

Meridian Michigan -
Michigan

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Job Details

Full-time
$75,300 - $135,400 a year
9 days ago

Benefits

Paid holidays
Health insurance
401(k)
Tuition reimbursement
Paid time off

Qualifications

RN License

Full 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.

**This role requires up to 75% local travel to support members in Wayne and Macomb counties. Applicants have the flexibility to work remotely from their home the remaining time. We provide all required equipment and reimburse for mileage at the current IRS rate. The schedule is Monday - Friday, 8am - 5pm.**

Position Purpose: Assesses, plans, and implements complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers on services and benefit options available to receive appropriate high-quality care.

Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialist, and/or community resources needed to address member's unmet needs
Coordinates and manages 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
Monitors care plans / service plans and/or 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
May identify problems/barriers for care management and appropriate care management interventions for escalated cases
Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
Reviews referrals information and intake assessments to develop appropriate care plans/service plans
May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed
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
Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner
May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness
Provides guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice
Engages and assists New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success
Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness
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 or Nursing or a Bachelor's degree in Nursing and 4 – 6 years of related experience.

License/Certification:

RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Pay Range: $75,300.00 - $135,400.00 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, 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

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