Care Manager, RN

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

📋 Description

• Strategize, design, execute, and provide timely oversight of care plans for members with recognized Care Management needs.

• Enhance the coordination, continuity, accessibility, and appropriate use of healthcare services and community resources.

• Create, maintain, and oversee processes for the timely identification and assessment of high-risk and special-needs members.

• Collaborate as an interdisciplinary team member and conduct clinical/social determinants of health assessments.

• Perform telephone or in-person interviews with members to identify risk factors and care management requirements.

• Establish professional relationships with service and resource providers.

• Initiate, develop, plan, and implement care plans.

• Use clinical judgment to discharge members from care management.

• Keep care management records and ensure data integrity in health plan information systems.

• Gather, assess, and report clinical, functional, and program activity data.

• Educate members' medical providers on special needs.

• Coordinate with community support and social service systems.

• Decrease care costs through service coordination and multidisciplinary collaboration.

• Assist in the development of care management policies and procedures.

• Communicate departmental updates, member status, program developments, and compliance issues to the supervisor/manager.

• Uphold patient confidentiality in accordance with HIPAA regulations.

• Identify and report deficiencies in the service delivery system.

⛳️ Requirements

• Registered Nurse with a current state license.

• Minimum of 2 years of clinical nursing experience in acute care or community settings.

• Proven experience assisting members through community agencies.

• 2 years of experience in care management.

• Proficiency in utilizing Microsoft Office suite and common computer and office equipment.

• Ability to conduct presentations and training for both small and large groups.

• Familiarity with the Americans with Disabilities Act of 1990.

• Demonstrated proficiency in written and oral communication, including presentations and training.

• Knowledge of Managed Care Programs (preferred).

• BSN (preferred).

• CCM (preferred).

🏝️ Benefits

• Medical, dental, and vision plans.

• 100% employer-sponsored Term Life Insurance.

• Short and Long-Term Disability coverage.

• 401k Employer Match up to 4%.

• 20 days of Paid Time Off (PTO).

• Tuition assistance and professional development plans.

• Flexible work arrangements.

• Organization-wide social opportunities.

• Commitment to Diversity, Equity, and Inclusion.