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Care Manager – SNP
WVU MedicineLead Care Manager responsible for coordinating care for SNP members, ensuring high-quality healthcare management. Collaborating with teams to maintain care plans and compliance with health regulations.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management and coordination for SNP members, ensuring compliance with CMS SNP Model of Care expectations and managing transitions of care effectively. Possesses strong clinical experience and a solid understanding of Medicare and Medicaid regulations.
Highest-signal resume keywords
Registered Nurse LicenseCare Management ExperienceSNP Care Management ExperienceHealthcare Clinical ExperienceBachelor's Degree in Nursing
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 CoordinationCare Plan DevelopmentCompliance ManagementMember Self-Referral ManagementInterdisciplinary Team Collaboration
Soft Skills
CommunicationCollaborationLiaison Skills
Industry Keywords
CMS SNP Model of CareNCQA StandardsMedicare AdvantageMedicaidSNP Populations
About the role
Key responsibilities & impact- Providing coordination of care to SNP members, including establishing and maintaining a care plan.
- Coordinating care with ICT members and coordinating care during transitions of care.
- Acting as a liaison for the Interdisciplinary Care Team (ICT) in conjunction with the PCP and beneficiary/caregiver.
- Collaborating with other CM team members to support the beneficiary through TOC events.
- Managing and triaging member self-referrals to care management programs.
- Assisting in ensuring compliance with CMS SNP Model of Care (MOC) expectations, NCQA standards, and Medicare Advantage regulatory requirements.
Requirements
What you’ll need- Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC).
- Three (3) years of healthcare clinical experience.
- One (1) years Care Management, Case Management or Population Health experience.
- Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma.
- Management of Medicare and/or Medicaid and/ or SNP populations.
- One (1) year SNP Care Management experience.
Benefits
Comp & perks- Health insurance
- Competitive salary
- Paid time off