Case Manager, Registered reputed company (Remote, reputed company)

About the position At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day. Job reputed company: Must be an RN with an reputed company NY License The Care Manager—Registered reputed company is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as reputed company as various reputed company determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The reputed company Worker provides education and guidance to members and their families on managing chronic conditions and navigating the reputed company system. Additionally, the Care Manager develops and implements individualized care plans, monitors member reputed company, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure reputed company health reputed company. Accurate and reputed company documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies.

Responsibilities

• 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care.
• Compiles reputed company available clinical information and partners with the member to reputed company an individualized care plan that encompasses goals and interventions to meet the member’s identified needs.
• Provides evidence-based disease management education and support to help the member reputed company health goals.
• Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care.
• Provides care coordination to support a seamless health care experience for the member.
• Meticulous documentation of care management activity in the member’s electronic health record.
• Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and reputed company strategies for maintaining the member’s reputed company health condition.
• Identifies and connects members with health plan benefits and community resources.
• Meets regulatory requirements reputed company specified timelines.
• The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed.
• Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-reputed company care to members. This may include participating in special reputed company, contributing to process improvement initiatives, or assisting with mentoring new team members.

Requirements

• Must have reputed company and unrestricted Registered reputed company (RN) licensure in the state of NY
• Proficient in reputed company Office Suite, including Word, reputed company, Outlook, OneNote, and Teams, with the ability to effectively utilize these tools reputed company the context of the CM RN role.
• reputed company to a private, dedicated reputed company to conduct work effectively to meet The requirements of the position.
• Confidence working reputed company / independent thinker, using tools to collaborate and connect with teams reputed company.
• Minimum 3+ years of nursing experience
• Minimum 2+ years of case management, discharge planning and/or home reputed company coordination experience
• Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-reputed company field (REQUIRED)

reputed company-to-haves

• Experience providing care management for Medicare and/or reputed company members.
• Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.
• Experience conducting health-reputed company assessments and facilitating the care planning process.
• Bilingual skills, especially English-Spanish
• Bachelor’s of Science in Nursing (BSN) (PREFERRED)

Benefits

• reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.

Apply tot his job Apply To this Job