RN Care Manager - Remote, nationwide

Become a part of our caring community and help us put health first

The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations.

The first 4 weeks of training will be from 8:30AM to 5:00PM EST. No time off is permitted during the first month of training.
Following training, the start time is 10:00AM EST.

Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence, while using a multidisciplinary team.

This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are work at home associates, working from a dedicated home office space. Work at home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all time with demonstrated advanced communication and interpersonal skills.

This is a very compliance driven and highly visible program  nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an auto dialer system. Environment is fast paced and requires ability to engage quickly with member while concurrently navigating multiple computer applications. Due to the auto dialer process and compliance needs of the business there is limited day to day flexibility in care manager’s schedule.

• Telephonically assess Medicare, Medicaid, and/or and Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals
• Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)
• Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc.
• Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
• Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention

• Active Registered Nurse (R.N.) license with no disciplinary action.
• Hold an active Compact nursing license and
  reside in the state that holds your compact license.
• The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. License must be current with no disciplinary action.
• Minimum education of an Associates degree in Nursing.
• Seasoned RN with a minimum of 3 years of clinical nursing experience.
• Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of individualized care planning.
• Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors.
• Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.
• Experience with Microsoft and Excel
• Ability to quickly learn and navigate software programs and applications.
• Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
• Effective communication and interpersonal skills.
• Effective problem solving and appropriate application of clinical knowledge
• Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.
• Must possess advanced telephonic and virtual communication skills.

• BSN or MSN degree in nursing or equivalent
• Previous adult chronic conditions care management
• Previous experience in care management including knowledge of complex care management and care management principles
• Experience with motivational interviewing
• Experience with MCG or CMS guidelines, assessment and documentation practice
• Case Management certification (CCM)
• Bilingual in English and Spanish

To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the…