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Care Manager – SNP
Peak HealthRegistered Nurse coordinating care plans, transitions, and resources for Peak Health’s Medicare Advantage SNP members. Supporting compliance, quality oversight, and member outcomes remotely.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Care Management and Case Management, with a strong focus on coordinating care for SNP members and ensuring compliance with CMS and NCQA standards. Proficient in developing individualized care plans and conducting assessments to enhance member quality of life.
Highest-signal resume keywords
Registered Nurse LicenseCare Management ExperienceKnowledge of CMS Regulatory StandardsExperience with Medicare AdvantageProficiency with Microsoft Office
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care Plan DevelopmentIntake AssessmentQuality AuditingHealth Risk Assessment ReviewCase ManagementDisease ManagementUtilization ManagementDischarge PlanningMember Record ReviewCare Coordination
Soft Skills
Excellent CommunicationProblem-SolvingAttention to DetailAbility to Work Under StressTime Management
Certifications & Qualifications
Registered Nurse LicenseMulti-State RN License (eNLC)
Industry Keywords
SNP Care ManagementMedicareMedicaidNCQA AccreditationHealthcare Clinical Experience
About the role
Key responsibilities & impact- Provide coordination of care to SNP members, including establishing and maintaining care plans
- Coordinate care with Interdisciplinary Care Team members and during transitions of care
- Participate in care management program build, implementation, oversight, and delegation
- Conduct intake assessments with members and families
- Develop individualized care plans accounting for physical, financial, and other constraints
- Serve as liaison for the Interdisciplinary Care Team with PCPs and beneficiaries/caregivers
- Provide resources and benefits education to beneficiaries/caregivers to improve self-management and quality of life
- Collaborate with care management team members to support beneficiaries through transitions of care
- Act as primary contact for members/caregivers, PCPs, specialists, and ancillary providers
- Audit member records using NCQA standards
- Review Health Risk Assessment data to guide programs and services
- Manage and triage member self-referrals to care management programs
- Participate in case management and quality committees
- Review medical records and investigate potential quality-of-care issues
- Assist with quarterly reporting of delegated case management processes
- Connect members with in-network providers and community resources
- Identify barriers to members achieving maximum quality of life
- Perform virtual face-to-face visits when needed
- Help ensure compliance with CMS SNP Model of Care, NCQA standards, and Medicare Advantage requirements
Requirements
What you’ll need- Current Registered Nurse license issued by the state where services will be provided, or current multi-state RN license through the enhanced Nurse Licensure Compact (eNLC)
- Three years of healthcare clinical experience
- One year of Care Management, Case Management, or Population Health experience
- Preferred: Bachelor's Degree in Nursing, Associate of Science in Nursing degree (ASN), or Diploma
- Preferred: Experience managing Medicare, Medicaid, and/or SNP populations
- Preferred: One year of SNP Care Management experience
- Knowledge of CMS regulatory and contractual documents
- Knowledge of Medicare Advantage, NCQA accreditation standards, disease management, utilization management, care management, and discharge planning
- Excellent written and oral communication
- Problem-solving capabilities
- Attention to detail
- Proficiency with Microsoft Office products
- Ability to work under stressful conditions
- Ability to meet defined deadlines and deliverables
- Ability to stand and walk short distances for eight or more hours
- Frequent bending, stooping, or stretching
- Ability to lift 30 pounds and push 50 pounds
Benefits
Comp & perks- 🌐 Worldwide ❌ Jobs You've Hidden ⭐️ Saved Jobs ✅ Applied Jobs ✉️ Email Alerts 👤 Account Peak Health Website LinkedIn All Job Openings 51 - 200 employees 🏥 Healthcare 💼 Consulting 🛡️ Insurance Healthcare
- Consulting
- Insurance Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. It is owned by three not-for-profit health care providers: WVU Health System, Marshall Health Network, and Valley Health. Peak Health aims to improve community health outcomes by offering an inclusive, provider-led health plan for residents of West Virginia and surrounding areas. The company is committed to making health care more accessible, understandable, and collaborative, with a focus on reducing costs and administrative fees for patients and employers. Peak Health also offers Medicare Advantage coverage tailored for West Virginia seniors through partnerships with leading health systems. Care Manager – SNP 🔥 1 minute ago 🇺🇸 United States – Remote ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager Apply Now Customize resume + cover letter Report problem ☆ Save ☑️ Mark as applied ❌ Hide 📋 Description
- Provide coordination of care to SNP members, including establishing and maintaining care plans
- Coordinate care with Interdisciplinary Care Team members and during transitions of care
- Participate in care management program build, implementation, oversight, and delegation
- Conduct intake assessments with members and families
- Develop individualized care plans accounting for physical, financial, and other constraints
- Serve as liaison for the Interdisciplinary Care Team with PCPs and beneficiaries/caregivers
- Provide resources and benefits education to beneficiaries/caregivers to improve self-management and quality of life
- Collaborate with care management team members to support beneficiaries through transitions of care
- Act as primary contact for members/caregivers, PCPs, specialists, and ancillary providers
- Audit member records using NCQA standards
- Review Health Risk Assessment data to guide programs and services
- Manage and triage member self-referrals to care management programs
- Participate in case management and quality committees
- Review medical records and investigate potential quality-of-care issues
- Assist with quarterly reporting of delegated case management processes
- Connect members with in-network providers and community resources
- Identify barriers to members achieving maximum quality of life
- Perform virtual face-to-face visits when needed
- Help ensure compliance with CMS SNP Model of Care, NCQA standards, and Medicare Advantage requirements 🎯 Requirements
- Current Registered Nurse license issued by the state where services will be provided, or current multi-state RN license through the enhanced Nurse Licensure Compact (eNLC)
- Three years of healthcare clinical experience
- One year of Care Management, Case Management, or Population Health experience
- Preferred: Bachelor's Degree in Nursing, Associate of Science in Nursing degree (ASN), or Diploma
- Preferred: Experience managing Medicare, Medicaid, and/or SNP populations
- Preferred: One year of SNP Care Management experience
- Knowledge of CMS regulatory and contractual documents
- Knowledge of Medicare Advantage, NCQA accreditation standards, disease management, utilization management, care management, and discharge planning
- Excellent written and oral communication
- Problem-solving capabilities
- Attention to detail
- Proficiency with Microsoft Office products
- Ability to work under stressful conditions
- Ability to meet defined deadlines and deliverables
- Ability to stand and walk short distances for eight or more hours
- Frequent bending, stooping, or stretching
- Ability to lift 30 pounds and push 50 pounds Apply Now 📊 Check your resume score for this job Improve your chances of getting an interview by checking your resume score before you apply. Check Resume Score Similar Jobs Senior Program Control Manager 🔥 1 minute ago Applied Research Solutions 501 - 1000 💼 Consulting 📦 Logistics 🏭 Manufacturing Website LinkedIn All Job Openings Senior Program Control Manager leading division-level finance and business operations for ARS, a defense and intelligence solutions provider. Managing budgets, forecasts, financial controls, and program performance across remote teams. 🇺🇸 United States – Remote ⏰ Full Time 🟠 Senior 👔 Manager Senior Manager, Enterprise OS, Virtualization 🔥 14 minutes ago Hewlett Packard Enterprise 10,000+ employees 🏢 Enterprise 🔧 Hardware ☁️ SaaS Website LinkedIn All Job Openings Senior manager leading HPE’s global enterprise OS and virtualization infrastructure modernization. Unifying teams and deploying AI-enabled automation across Windows, Linux/UNIX, VMware, and HVM platforms. 🇺🇸 United States – Remote 💵 $119.5k - $275k / year ⏰ Full Time 🟠 Senior 👔 Manager 🦅 H1B Visa Sponsor Regional Manager – Ostomy Care 🔥 29 minutes ago Coloplast 10,000+ employees 🏭 Manufacturing 🏥 Healthcare Website LinkedIn All Job Openings Regional Sales Manager leading Florida sales teams for Coloplast, a medical device company specializing in intimate healthcare products. Driving Ostomy Care growth, customer relationships, and regional profitability. 🇺🇸 United States – Remote 💵 $210k - $240k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager 🦅 H1B Visa Sponsor Vertical Markets Manager 🔥 33 minutes ago American Tower 5001 - 10000 📦 Logistics 📡 Telecommunications 🏠 Real Estate Website LinkedIn All Job Openings Vertical Markets Manager leasing tower sites and related digital infrastructure for American Tower. Developing accounts, proposals, customer relationships, budgets, and Salesforce pipeline forecasts. 🇺🇸 United States – Remote 💵 $99k - $133.5k / year ⏰ Full Time 🟠 Senior 🔴 Lead 👔 Manager 🦅 H1B Visa Sponsor Application Manager 🔥 50 minutes ago S&C Electric Company 1001 - 5000 ⚡ Energy 🔧 Hardware 🏭 Manufacturing Website LinkedIn All Job Openings Application Manager providing pre-sales technical expertise for S&C Electric’s electrical-grid products. Supporting customer applications, proposals, product trials, and sales conversion across the Great Lakes region. 🇺🇸 United States – Remote 💵 $105.9k - $140.4k / year ⏰ Full Time 🟡 Mid-level 🟠 Senior 👔 Manager 🦅 H1B Visa Sponsor View More Manager Jobs 🌐 Worldwide Built by Lior Neu-ner. I'd love to hear your feedback — Get in touch via DM or support@remoterocketship.com Search Search Jobs by country Search jobs by city Search jobs by job title Search entry-level jobs Search junior-level jobs Search senior-level jobs Search jobs by tech stack Search jobs by contract type Search remote internships Search remote part-time jobs Remote jobs Anywhere in the World Companies Hiring Anywhere in the World Companies Hiring Sales People Anywhere in the World Companies Hiring Software Engineers Anywhere in the World Resources Advice Tips for finding remote jobs Interview questions and answers Resume examples Cover letter examples Post a job Affiliates About us Is Remote Rocketship legit? Privacy policy Terms of service Job board SEO course Remote Job Search MasterClass AI Apply Copilot OpenClaw job finder Find jobs using your resume Jobs by Country Remote jobs anywhere in the world (Worldwide remote jobs) Remote jobs United States Remote jobs Australia Remote jobs Brazil Remote jobs Canada Remote jobs France Remote jobs Ireland Remote jobs Germany Remote jobs Netherlands Remote jobs Spain Remote jobs UK Popular Jobs Remote data analyst jobs Remote customer support jobs Remote executive assistant jobs Remote marketing jobs Remote product designer jobs Remote product manager jobs Remote project manager jobs Remote recruiter jobs Remote sales jobs Remote software engineer jobs Jobs by Type Remote full-time jobs Remote part-time jobs Remote contract jobs Remote internship jobs Remote entry-level jobs Remote jobs with no experience required Remote junior jobs (1-3 years of experience) Digital nomad jobs Remote jobs with no degree required Freelance remote jobs Temporary remote jobs Remote jobs hiring now Stay at home mom jobs