Care Manager, RN

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

📋 Description

• Design, evaluate, and implement intricate care management activities for members with predominantly physical needs.

• Develop individualized care plans and offer education to members and their families.

• Assess member requirements, barriers to access, and social determinants of health.

• Formulate continuous care/service plans and collaborate with providers, specialists, and community resources.

• Identify issues and obstacles to care and deliver care management interventions.

• Coordinate between members, families/caregivers, and care provider teams to ensure appropriate, person-centered care.

• Monitor and follow up on member status, changes in condition, and progress towards care plan objectives.

• Offer resource support for employment, housing, participant direction, independent living, justice, and foster care services.

• Facilitate prompt access to necessary care and services.

• Conduct outreach via telephone, digital platforms, home visits, and other locations.

• Gather, document, and maintain member information and care management activities to ensure regulatory compliance.

• Educate members and caregivers regarding disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits.

• Provide leadership with feedback on opportunities to enhance care quality and cost-effective service delivery.

• Execute other assigned duties and comply with all policies and standards.

⛳️ Requirements

• A degree from an accredited nursing school or a Bachelor’s degree in Nursing.

• 2–4 years of relevant experience.

• RN - Registered Nurse - State Licensure and/or Compact State Licensure is mandatory.

• For YouthCare Illinois plan only: A Bachelor’s Degree and IL RN licensure are required; candidates must reside in IL.

• For Sunshine Health (FL) only: A minimum of two years of pediatric experience is required for employees supporting Florida's Children’s Medical Services (CMS).

• For Trillium Community Health Plan only: RN licensure in Oregon is required.

• May necessitate up to 80% local travel for Sunshine Health (FL) CMS employees.

• Ability to adhere to policies, standards, and relevant regulatory requirements.

🏝️ Benefits

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible working arrangements with remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in overall compensation.

• Equal opportunity employer dedicated to diversity.