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About the role
Key responsibilities & impact- Provides care management services for Select Health members across all lines of business.
- The nurse care manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs.
- The position educates patients and caregivers to help them manage their health care needs.
- The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management.
- This position is responsible for developing, documenting and implementing care plans, which will provide the appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs.
- Identifies members unable to adhere to a medical plan or members that require complex additional assistance and enrolls and follows these members in longitudinal care management services.
Requirements
What you’ll need- Current license to practice as a Registered Nurse in the state of residence.
- Demonstrated experience and expertise working in clinical nursing.
- Minimum 1-year experience in care management/navigation or closely related field including Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health, quality, or patient educator job role.
- Strong written, verbal communication and conflict resolution skills.
- Intermediate computer software and hardware skills, ability to customize computer settings and use multiple monitors and capable of independent troubleshooting internet and applications.
- RNs hired or promoted into this role need to have or obtain their BSN within three years of hire or promotion.
- Bachelor's degree in nursing (BSN) from an accredited institution (degree will be verified).
- Case Management Certification.
- Three years of experience and expertise working in clinical nursing in an ambulatory care setting, community health or home care.
- Experience working with third party payers.
Benefits
Comp & perks- We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
care managementclinical nursingUtilization Managementdischarge planningmanaged carehealth promotionhealth coachingbehavioral healthpatient educationcase management
Soft Skills
communicationconflict resolution
Certifications
Registered Nurse licenseCase Management Certification
