[Hiring] Government Programs RN Care Manager III @Tailored Management

Role Description

We are seeking an experienced Government Programs RN Care Manager III to support SNP members through the care management process. This fully remote role is ideal for a Registered Nurse who has strong clinical judgment, case management experience, and the ability to support members telephonically with compassion, professionalism, and attention to detail.

In this role, the Care Manager will:

• Assess, plan, implement, coordinate, monitor, and evaluate care options and services to help members improve health outcomes while navigating illness, injury, and barriers to care.
• Utilize strong communication skills, work independently, and adopt a patient-centered approach to education, advocacy, and care coordination.

Key Responsibilities

• Establish collaborative relationships with members, families, physicians, and other providers to assess medical history, current health status, treatment needs, and care options.
• Assess member health status and treatment plans to identify gaps in care, barriers to healthcare access, and opportunities for improved outcomes.
• Develop and document patient-centered care management plans involving appropriate parties, including members, providers, physicians, and other care partners.
• Identify anticipated outcomes, case goals, criteria for case closure, and communication plans for all parties involved.
• Implement, coordinate, monitor, and evaluate care management plans on an ongoing basis.
• Promote member education, health advocacy, and consumerism to support informed healthcare decisions.
• Maintain compliance with professional practice standards, scope of licensure, certification requirements, quality assurance standards, and all care management policies and procedures.
• Participate in unit and corporate training initiatives and maintain continuing education to support clinical expertise and certification requirements.
• Demonstrate sensitivity and professionalism when working with culturally diverse members, clients, and customers.
• Meet care management expectations and performance metrics in a monitored, telephonic environment.

Qualifications

• Active, unrestricted Registered Nurse license in a U.S. state or territory.
• Compact RN license is required for this role.
• Minimum of 2 years of full-time direct clinical care experience with patients/consumers.
• Strong verbal and written communication skills.
• Ability to work independently in a fully remote, telephonic care management environment.
• Strong documentation, organization, and care coordination skills.
• Ability to partner effectively with internal teams, external providers, members, and families.

Work Environment

This is a fully remote position with no onsite or hybrid requirement. Candidates must be able to work a consistent 40-hour schedule, Monday through Friday, completing 8 working hours each business day, excluding company holidays.