Jobs for Humanity is partnering with Sunshine State Health Plan to build an inclusive and just employment ecosystem. Therefore, we prioritize individuals coming from the following communities: Refugee, Neurodivergent, Single Parent, Blind or Low Vision, Deaf or Hard of Hearing, Black, Hispanic, Asian, Military Veterans, the Elderly, the LGBTQ, and Justice Impacted individuals. This position is open to candidates who reside in and have the legal right to work in the country where the job is located.

Company Name: Sunshine State Health Plan

Are you ready to make a difference in the lives of 28 million people? Join our Medical Management/Health Services team and be a clinical professional who promotes quality and cost-effective care for our diverse members. At Centene, we value workplace flexibility and offer competitive benefits to enhance your experience.

Position Purpose:

• Assess, plan, and coordinate medical and support services for select members to ensure high-quality and cost-effective care
• Develop, adjust, and evaluate care plans to achieve desired outcomes
• Evaluate member's health status, treatment plans, and provider options
• Coordinate services between medical providers, specialists, and non-medical staff to address members' holistic needs
• Create intervention plans with specific objectives and goals to meet members' unique needs
• Provide education to patients and providers
• Facilitate access to community-based services
• Monitor referrals to support members' overall care management
• Participate actively in integrated team care management rounds
• Identify quality concerns and report them to the appropriate resources
• Maintain accurate and up-to-date records in medical management systems
• Travel up to 30% of the time for home visits (for LTSS)

Education/Experience: Successful completion of an Accredited School of Nursing and preferably, a Bachelor's degree in Nursing. Two or more years of clinical nursing experience in various settings. Knowledge of healthcare and managed care is advantageous.

Licenses/Certifications: Current state RN license is required.

Location: This position has a hybrid work model. Candidates must reside in or around Miami Gardens - Dade County, FL.

For Sunshine Health (FL) Only: Candidates supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience. Local travel of up to 80% may be required.

Our Comprehensive Benefits Package:

• Flexible work solutions, including remote work options and hybrid schedules
• 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 opportunities

Centene is an equal opportunity employer and celebrates diversity in all forms. We welcome applicants from diverse backgrounds, including seniors, refugees, individuals with visible and invisible disabilities, LGBTQIA+ individuals, veterans, and more. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by applicable law.

If you are interested in joining our team, please fill out the form below:

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