Hybrid Registered Nurse (RN) Clinical Care Manager

Posted 5 hours ago

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About the role

  • Community based Registered Nurse focusing on clinical care management for dually-eligible enrollees with complex needs. Engaging enrollees and coordinating with healthcare providers for improved health outcomes and quality of life.

Responsibilities

  • Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship
  • Function as a liaison between healthcare providers, community resources, and enrollees
  • Perform required assessments on a timely basis
  • Engage enrollees in care plan development and implementation
  • Lead the interdisciplinary care team (ICT) and collaborate with peers 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 and available services
  • Provide education to members and their families about managing chronic conditions
  • Promote healthy lifestyle choices and self-management strategies
  • Assist enrollees in preventative health strategies
  • Follow up with members after hospitalizations or significant health events
  • Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care
  • Advocate for the needs and preferences of enrollees within the healthcare system
  • Evaluate member satisfaction through open communication and monitoring of concerns or issues
  • Report abuse, neglect, or exploitation of older adults and adults with disabilities

Requirements

  • Associates of Science (A.S) degree in nursing from an accredited nursing program required or Master's degree in social work or mental health counseling and independent license required
  • Three (3) years of experience as a Registered Nurse/BH Clinician or One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required
  • 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
  • Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers
  • Ability to manage multiple cases and priorities while maintaining attention to detail
  • Adhere to code of ethics that aligns with professional practice
  • Awareness of and sensitivity to the diverse backgrounds and needs of the populations served
  • Decision making and problem-solving skills
  • Ability to function independently and effectively as part of an interdisciplinary team
  • Strong and effective communication skills, both written and verbal
  • Strong interpersonal and customer relations skills
  • Strong customer service skills

Benefits

  • Health insurance
  • Flexible hours
  • Paid time off
  • Professional development opportunities
  • Influenza vaccination requirement

Job title

Registered Nurse (RN) Clinical Care Manager

Job type

Experience level

Mid levelSenior

Salary

$90,000 - $120,000 per year

Degree requirement

Associate's Degree

Location requirements

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