[Hiring] RN Care Manager @Point32Health

Role Description

The Care Manager – Nursing Field (RN CM) will ensure that all members receive timely care management (CM) across the continuum, including transitions of care, care coordination and navigation, complex case management, population health and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses strong clinical knowledge, critical thinking skills, and ability to facilitate a care plan which ensures quality medical care for the member. The RN CM works closely with the member, the caregiver/authorized representative, and providers to meet the targeted member-specific goals. Based on national standards for CM practice, the RN CM focuses on empowering the member to support optimal wellness and improved self-management.

Key Responsibilities/Duties

• Perform telephonic member outreach and/or face-to-face encounter utilizing key motivational interviewing skills to facilitate program enrollment.
• Perform departmental assessments and evaluate member holistically to identify needs, health goals, and barriers to wellness.
• Develop a member-specific plan of care, implement member-specific care manager interventions, and revise plan of care as needed.
• Complete documentation in applicable platform according to departmental policy and regulatory standards.
• Provide targeted health education, proactive strategies for condition management, and communication with key providers and vendors actively involved in the member’s care.
• Collaborate with member/caregiver and the facility care team to coordinate a safe transition to the next level of care.
• Collaborate and liaise with the interdisciplinary care team to improve member outcomes.
• Maintain professional growth and development through self-directed learning activities.

Qualifications

• Registered Nurse with current unrestricted license in state of residence.
• May be required to obtain other state licensure in states where Point32Health operates.
• Understand and follow the provisions of state-specific Nurse Practice Act(s) where Point32Health operates.
• National certification in Case Management desirable.
• Bachelor’s degree or relevant equivalent experience (minimum required).
• Bachelor’s degree in nursing preferred.
• 5 years’ relevant clinical experience (minimum required).
• Experience in home care or case management preferred.
• Proficiency in a second language desirable.
• Experience in specialty areas a plus.

Requirements

• Skill and proficiency in Microsoft applications, technical concepts and principles; computer software applications.
• Work cooperatively as a team member across multiple levels within the organization.
• Skilled in assessment, planning, and managing member care.
• Advanced communication and interpersonal skills.
• Independent and autonomous with key job functions.
• Ability to address multiple complex issues.
• Flexibility and adaptability to changing healthcare environment.
• Ability to organize and prioritize work and member needs.
• Demonstration of strong clinical and critical thinking skills.
• Regard for confidential data and adherence to corporate compliance policy.

Working Conditions and Additional Requirements

• Must be able to work under normal office conditions and work from remote office as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• Ability to make face-to-face visits (member home, provider practices, facilities) as needed to meet the member needs and produce positive outcomes.
• Valid Driver’s license and vehicle in good working condition as travel is required.
• May be required to work additional hours beyond standard work schedule.
• Other duties as assigned and needed by the department.

Benefits

• Medical, dental and vision coverage.
• Retirement plans.
• Paid time off.
• Employer-paid life and disability insurance with additional buy-up coverage options.
• Tuition program.
• Well-being benefits.
• Full suite of benefits to support career development, individual & family health, and financial health.

Salary Range

$87,091.58 - $130,637.38

COVID Policy

Please note: We encourage all Point32Health colleagues to follow CDC guidance about COVID-19 vaccines, boosters, isolation, and masking. Point32Health reserves the right to adjust its requirements in response to COVID-19 trends in the communities we serve.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

We welcome all

All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Scam Alert

Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment.