Job Description
Role Description
- This role involves developing, assessing, and facilitating complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes.
- Evaluates the needs of the member, barriers to accessing appropriate care, and social determinants of health needs.
- Develops ongoing care plans/service plans and collaborates with providers to identify resources to address member's unmet needs.
- Identifies problems/barriers to care and provides appropriate care management interventions.
- Coordinates between the member and/or family/caregivers and the care provider team to ensure adequate and appropriate person-centered care.
- Provides ongoing follow-up and monitoring of member status, change in condition, and progress towards care plan/service plan goals.
- Provides resource support to members and care managers for local resources for various services based on service assessment and plans.
- Facilitates care management and collaborates with appropriate providers or specialists to ensure timely access to needed care or services.
- May perform telephonic, digital, home, and/or other site outreach to assess member needs and collaborate with resources.
- Collects, documents, and maintains all member information and care management activities to ensure compliance with regulations.
- Provides and/or facilitates education to members and their families/caregivers on disease processes and healthcare options.
- Provides feedback to leadership on opportunities to improve care and quality delivery for members.
- Performs other duties as assigned.
- Complies with all policies and standards.
- Qualifications
- Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing.
- 2 – 4 years of related experience.
- Requirements
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required.
- Benefits
- Competitive pay
- Health insurance
- 401K and stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field, or office work schedules
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