Senior Care Manager, RN

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

📋 Description

• Evaluate, strategize, and execute intricate care management activities.

• Create individualized care/service plans tailored for members.

• Resolve member concerns while educating members and their families/caregivers about available services and benefit options.

• Continuously assess care plans and work collaboratively with providers and community resources.

• Coordinate efforts among members, caregivers, and care provider teams to ensure that person-centered care is delivered effectively.

• Track member status, changes in health conditions, progress, and goals outlined in care plans.

• Identify obstacles and interventions for more complex cases.

• Analyze member data, referrals, and intake assessments to enhance quality and operational performance.

• Conduct outreach through telephonic, digital, home visits, and other sites as needed.

• Partner with healthcare providers to facilitate access to services and treatments.

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

• Educate on disease management, care gaps, provider instructions, care options, referrals, and healthcare benefits.

• Collaborate with leadership to enhance the delivery of care and quality in a cost-effective manner.

• May mentor new clinical hires, offer coaching, foster development, and oversee onboarding processes.

• Assist new clinical hires/preceptees in navigating a Managed Care Organization.

• Complete competency assessments and monitor readiness for successful Service Coordination.

• Work alongside People Leaders and cross-functional teams to evaluate and track readiness.

• Perform other assigned duties while adhering to company policies and standards.

⛳️ Requirements

• A degree from an accredited nursing program or a Bachelor's degree in Nursing.

• 4–6 years of relevant experience.

• RN state licensure and/or compact state licensure is mandatory.

• WA State RN licensure and/or compact state licensure is essential.

• Availability to work Monday–Friday, from 8:00 am to 5:00 pm Pacific Standard Time.

• Adherence to state, federal, and third-party payer regulations is required.

• Familiarity with care management, personalized care plans, member assessments, healthcare benefits, referrals, and provider coordination.

🏝️ Benefits

• Competitive salary.

• Comprehensive health insurance.

• 401K retirement plan.

• Stock purchase plans.

• Tuition reimbursement opportunities.

• Paid time off plus holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional incentive programs may be included in the overall compensation package.

• An equal opportunity employer dedicated to diversity.