Integrated Care Manager, RN
ZING. Enamel Whitening. Toothpaste, but magic.
full-time
Posted on:
Location Type: Remote
Location: Remote • Illinois • 🇺🇸 United States
Visit company websiteSalary
💰 $82,000 - $92,000 per year
Job Level
Mid-LevelSenior
About the role
- Conducting health risk assessments
- Coordination of care
- Care management for MAPD, C-SNP, and D-SNP members
- Follows the patient through various transitions of care to ensure that any gaps in treatment plans are identified and remedied.
- Promoting efficient health care delivery.
- Participates in assessment activities to develop individualized care plans in coordination with the patient, family, and providers.
- Serves as a member advocate and resource, and provides critical information and recommendations to the rest of the care team.
- Maintains strong knowledge of Case management, community resources, and plan benefits to promote improved member experience and health outcomes.
- Works collaboratively with the member (and caregivers), primary care physicians, specialists, and other care providers to ensure member compliance and adherence to the medical plan of care.
- Assists the Health Services Team in implementing best practices for chronic care and disease management.
- Provides member education to assist with self-management and encourages members to make healthy lifestyle changes.
Requirements
- Registered Nurse (RN) with 3 years of direct clinical care to the consumer in a clinical setting.
- Current, valid, unrestricted license
- 3 years of managed care experience or other commensurate experience
- Demonstrates strong clinical knowledge, ability to perform clinical assessments.
- Knowledge of plan benefit designs.
- Demonstrated ability to perform case management & disease management activities.
- Ability to demonstrate knowledge of and apply those to the job function and responsibilities.
- Problem-solving skills: the ability to systematically analyze problems, draw relevant conclusions, and devise appropriate courses of action.
- Verbal and written communication skills, including listening, discussing, and documenting medical needs with members, providers, internal staff/management, external vendors, and community resources.
- PC proficiency to include Outlook, Word, Excel, database experience, and web-based applications.
- Personal management skills — Plan and manage multiple assignments and tasks, set priorities, and adapt to changing conditions and work assignments.
- Teamwork — ability to work well with one or more groups.
- Interpersonal effectiveness — Relate to co-workers and build relationships with others in the organization.
Benefits
- Medical, Dental, and Vision
- Employer-Paid Life Insurance
- 401(K) match up to 4%
- Paid-Time-Off
- Several supplemental benefits are available, including, but not limited to, Spouse Insurance, Pet Insurance, Critical Illness coverage, ID Protection, etc.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
health risk assessmentscare managementclinical assessmentscase managementdisease managementmanaged care experienceplan benefit designsmember educationchronic care managementself-management
Soft skills
problem-solvingverbal communicationwritten communicationinterpersonal effectivenessteamworkorganizational skillsadaptabilityrelationship buildingcollaborationmember advocacy
Certifications
Registered Nurse (RN)current valid unrestricted license