Care Manager, RN

Job Description:

• Lead complex care management for members with primarily physical health needs
• Conduct comprehensive assessments and evaluate member needs, barriers to care, and social determinants of health
• Develop personalized, ongoing care plans and service plans
• Coordinate care among members, families, caregivers, providers, specialists, and community resources
• Identify problems and barriers to care and provide appropriate interventions
• Monitor member status, changes in condition, and progress toward care plan goals
• Provide resource support for services such as employment, housing, independent living, justice, and foster care
• Facilitate timely access to needed care and services
• Conduct telephonic, digital, home, and/or other site outreach
• Collect, document, and maintain member information and care management activities for regulatory compliance
• Educate members and families/caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits
• Provide leadership feedback on opportunities to improve care quality and cost-effective delivery
• Support PHCO Case Management and collaborate with cross-functional Medicaid teams
• Comply with all policies and standards and perform other assigned duties

Requirements:

• Required credential: Registered Nurse (RN)
• Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing
• 2–4 years of related experience
• RN (Registered Nurse) state licensure and/or compact state licensure required
• Schedule availability from 8:00 a.m.–5:00 p.m. Eastern Time
• Candidates must reside in Georgia

Benefits:

• Competitive pay
• Health insurance
• 401K plan
• Stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules
• Total compensation may include additional forms of incentives