Registered Nurse managing clinical care for dual-eligible enrollees in the community. Focusing on integrating health services and community resources for better health outcomes.
Responsibilities
Provide monitoring, follow-up, and clinical care management to dually-eligible enrollees
Engage with the enrollee in their homes and other community settings
Function as a liaison between healthcare providers, community resources, and enrollees
Perform required assessments on a timely basis
Lead the interdisciplinary care team and collaborate to create holistic care plans
Oversee enrollee utilization of long-term services and supports
Assist members in accessing community resources
Educate members about their benefits under Medicare and Medicaid
Follow up with members after hospitalizations to ensure continuity of care
Requirements
Associates of Science (A.S) degree in nursing or Master's degree in social work/mental health counseling and independent license required
Three (3) years of experience as a Registered Nurse/BH Clinician or one (1) year as Registered Nurse/BH Clinician with two (2) years of experience in related fields
Prior experience in care coordination, case management, or working with dual-eligible populations preferred
Medicaid and/or Medicare managed care experience preferred
Intermediate proficiency level with Microsoft Office, including Outlook, Word, and Excel
Understanding of Medicare and Medicaid programs, and community resources for dual-eligible beneficiaries
Benefits
Influenza vaccination is a requirement of this position
Comprehensive total rewards package
Reasonable accommodations to qualified individuals with disabilities
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