Care Manager, RN

Job Description:

• Develop, assess, and facilitate complex care management activities for members with primarily physical needs
• Evaluate member needs, barriers to care access, and social determinants of health
• Develop ongoing care plans and collaborate with providers, specialists, and community resources
• Identify problems and barriers to care and provide appropriate interventions
• Coordinate among members, families/caregivers, and care provider teams
• Follow up and monitor member status, condition changes, and progress toward care-plan goals
• Provide resource support for services including employment, housing, participant direction, independent living, justice, and foster care
• Facilitate care management and collaborate with providers to ensure timely access to care
• 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 benefits
• Provide leadership feedback on opportunities to improve care quality and cost-effectiveness
• Perform other assigned duties and comply with policies and standards

Requirements:

• Preference will be given to applicants who reside in eastern or central time zone
• Active Kentucky State or Compact RN license required
• Experience with medical-surgical or other inpatient units, clinical outpatient settings such as home health, or care management preferred
• 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
• Complies with all policies and standards

Benefits:

• competitive pay
• health insurance
• 401K
• 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 also include additional forms of incentives