Remote Complex Discharge Planner, Missouri

Centene

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Business Area: Clinical & Care Management
Job Type: Full time
Date Posted: Jan 25 2024
Job Number: 1484310

Description

You could be the one who changes everything for our 28 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.

2 POSITIONS AVAILABLE.

THESE POSITIONS ARE REMOTE/WORK FROM HOME SUPPORTING MEDICARE, MEDICAID, DUAL ELIGIBLE AND MARKET PLACE INSURANCE PLAN MEMBERS/CONCURRENT REVIEW PROCESS.

WILL SUPPORT MULTIPLE LINES OF BUSINESS IN MULTIPLE STATES FOR POST ACUTE CARE, SKILLED NURSING, LONG TERM ACUTE CARE, INPATIENT AND NICU MEMBERS.

Position Purpose: Develops, assesses, and coordinates complex discharge plans for high-risk members based upon needs assessment. Assists with the facilitation of a smooth transition from the acute care setting to the next level of care and educates members and their families/caregivers on discharge plan to ensure appropriate high-quality transitional care.

  • Develops complex discharge plans based on level of care of members needs determined by needs assessment to ensure appropriate level of care
  • Interacts with providers, community agencies, and other utilization review staff to coordinate and ensure a safe, effective, and clinically appropriate transition plan for the member
  • Assists with managing member’s discharge plans to ensure a timely and smooth discharge between levels of care and facilities
  • Collects, documents, and maintains all discharge plans taken on member medical records in health management systems according to utilization management policies and guidelines
  • Assists with providing education to members and their families on discharge plan and utilization processes to ensure high quality appropriate care to members, as applicable
  • Provides feedback to leadership on opportunities to improve the discharge planning process for members to ensure high-quality transitional care
  • Coordinates and assists with completion of prior authorizations as they related to discharge planning, as applicable
  • Assists concurrent review team as needed
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 – 4 years of related experience.
Clinical knowledge of discharge planning competencies preferred.
Knowledge of Medicare and Medicaid regulations preferred.
Knowledge of utilization management processes preferred.

License/Certification:

  • LPN – Licensed Practical Nurse – State Licensure required

Pay Range: $24.52 – $43.99 per hour

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.