RN Care Manager

Position: Telephonic Nurse Care Manager

As a Telephonic Nurse Care Manager, you will assist members in navigating complex medical and behavioral health challenges. You will collaborate with a multidisciplinary clinical team, which includes healthcare professionals, care coordinators, and records specialists, to provide innovative and integrated remote care. A passion for engaging with members over the phone, actively listening to their needs, answering inquiries, and advocating for them is essential. You will be responsible for developing cohesive care plans and using your clinical expertise to guide members in accessing available benefits and resources. Your role will encompass managing complex care, disease management, and acute case management, ensuring members receive comprehensive care that leads to optimal health outcomes.

Key Responsibilities:

• Provide coordinated, patient-focused virtual Care Management via telephone and/or video to enhance health outcomes for members.
• Collaborate with members and our multidisciplinary team to create impactful care plans, helping members achieve their health goals.
• Assist members in navigating intricate medical conditions, treatment options, benefits, and the overall healthcare system.
• Work in partnership with local healthcare providers to ensure seamless coordination of care.
• Establish supportive relationships through compassionate, ongoing follow-up care.
• Support members during acute healthcare episodes, such as hospitalizations and rehabilitation, offering coordinated case management to assist members and their families.
• Coordinate essential resources to address both clinical and social needs holistically.

Qualifications:

• Bachelor of Science in Nursing (BSN) required.
• Current CCM Certification is preferred but can be completed after receiving an offer.
• Minimum of 5 years of nursing experience preferred, with at least 2 years in care management.
• Must reside in a compact NLC state AND must have California Nursing License
• Active Compact RN license in good standing required.
• Willingness to obtain and maintain licensure in multiple states.
• Availability to work until 6 PM PST (preference for candidates in MST/PST time zones).
• Comfort in discussing a wide range of medical conditions and experience with diverse populations across age groups.
• Spanish-speaking skills are desirable.
• Experience with remote work preferred; proficiency with technology and multiple computer/medical record systems is essential.
• A high degree of empathy is crucial, as you will be supporting patients and families during challenging times. Ideal candidates will demonstrate compassion and reassurance to those in need.
• Ability to work efficiently in a fast-paced environment; the capacity to balance priorities and meet volume goals without compromising quality is essential.
• Flexibility to adapt to a rapidly changing work environment.
• Adherence to security and HIPAA regulations to safeguard patients' medical information is required.
• A pleasant, responsive demeanor with a willingness to collaborate and learn from the team is essential.
• Strong verbal and written communication skills are critical. You will spend significant time communicating with patients, families, and colleagues, so the ability to gather clinical histories, address patient questions, and summarize findings succinctly is vital.
• Excellent grammar and attention to detail, with the ability to convey medical information in clear, patient-friendly language.