Care Manager – Nursing, Field

This is a fully remote position, open to applicants in Massachusetts.

📋 Description

• Conduct telephonic outreach to members and/or engage in face-to-face interactions using essential motivational interviewing techniques to promote program enrollment.

• Carry out departmental evaluations and assess members comprehensively to determine their needs, health objectives, and obstacles to achieving wellness.

• Collaborate with the member, caregiver, and healthcare providers to create a customized care plan, execute specific interventions by the care manager, and adjust the care plan as necessary.

• Ensure accurate documentation in the relevant platforms in accordance with departmental policies and regulatory guidelines.

• Deliver focused health education, proactive strategies for managing health conditions, and maintain communication with key providers and vendors actively engaged in the member’s care.

• Work alongside the member, caregiver, and the facility care team to ensure a safe transition to the next level of care, which includes confirming understanding of post-hospital discharge instructions, facilitating necessary services and follow-up, and implementing strategies to avert re-admission.

• Collaborate and communicate with the interdisciplinary care team to enhance member outcomes (e.g., Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness, and Behavioral Health CM).

• Attend and present high-risk members at interdisciplinary rounds as appropriate.

• Pursue professional growth and development through self-directed learning initiatives.

⛳️ Requirements

• Must be a Registered Nurse with a current unrestricted license in the state of residence.

• May need to acquire additional state licensure in locations where Point32Health operates.

• Must understand and adhere to the provisions of state-specific Nurse Practice Act(s) applicable to Point32Health operations.

• National certification in Case Management is preferred.

• A minimum of 5 years of relevant clinical experience is required.

• Experience in home care or case management is a plus.

• Proficiency in a second language is advantageous.

• Strong skills and proficiency in Microsoft applications, technical concepts, and software applications are necessary.

• Competence in assessment, planning, and overseeing member care is essential.

• Advanced communication and interpersonal abilities are crucial.

• Must be capable of addressing multiple complex issues effectively.

• Ability to organize and prioritize work and member needs is required.

• Must show respect for confidential information and comply with corporate compliance policies.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Retirement plans.

• Paid time off.

• Employer-sponsored life and disability insurance, with options for additional buy-up coverage.

• Tuition reimbursement program.

• Well-being benefits.

• Comprehensive benefits package to support career growth, individual and family health, and financial wellness.