Assesses, plans, and implements complex care management activities based on member activities
Develops personalized care plans/service plans and continuously assesses and revises them
Coordinates and manages between members/families/caregivers and care provider teams
Monitors member status, change in condition, and progress toward care plan goals
Reviews member data, referrals, and intake assessments to develop appropriate care plans
Performs telephonic, digital, home and/or other site outreach to assess member needs
Collaborates with healthcare providers to facilitate services and determine revised care plans
Collects, documents, and maintains all member information and care management activities
Provides education to members and families/caregivers on disease processes, care options, and benefits
May precept clinical new hires and provide coaching, shadowing, and competency check points
Partners with leadership to improve care and quality delivery in a cost-effective manner
Performs other duties as assigned and complies with all policies and standards
Requirements
Must have an active New York State Registered Nurse License
RN - Registered Nurse - State Licensure and/or Compact State Licensure required
Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing
4 – 6 years of related experience
Ability to perform telephonic, digital, home and/or other site outreach
Experience with care plan/service plan development and monitoring
Knowledge of state and federal regulations and third-party payer requirements
Ability to collaborate with healthcare providers and community resources
Experience with documentation and maintaining member information for compliance
Benefits
competitive pay
health insurance
401K and stock purchase plans
stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules
comprehensive benefits package including potential additional forms of incentives
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
care managementcare plan developmenttelephonic outreachdigital outreachhome outreachdocumentationmember assessmentmonitoring member statuscoachingcompetency check points