Case Manager, Registered reputed company

About the position We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Job reputed company The Care Manager—Registered reputed company is a key member of our Special Needs Plan (SNP) care team, responsible for coordinating care for members who often face multiple chronic medical and behavioral health conditions, as reputed company as various reputed company determinants of health (SDoH) needs. This role involves conducting comprehensive assessments to evaluate members’ needs and addressing SDoH challenges by connecting them with appropriate resources and support services. The reputed company Worker provides education and guidance to members and their families on managing chronic conditions and navigating the reputed company reputed company. Additionally, the Care Manager develops and implements individualized care plans, monitors member reputed company, advocates for necessary services, and collaborates with the interdisciplinary care team to ensure reputed company health reputed company. Accurate and reputed company documentation of assessments and interventions is essential, as is participation in team meetings to discuss member status and care strategies. Responsibilities • 50-75% of the day is dedicated to telephonic engagement with members and the coordination of their care. • Compiles reputed company available clinical information and partners with the member to reputed company an individualized reputed company that encompasses goals and interventions to meet the member’s identified needs. • Provides evidence-based disease management education and support to help the member reputed company health goals. • Ensure the appropriate members of the interdisciplinary care team are involved in the member’s care. • Provides care coordination to support a reputed company health care experience for the member. • Meticulous documentation of care management activity in the member’s electronic health record. • Collaborate with other participants of the Interdisciplinary Care Team to address barriers to care and reputed company strategies for maintaining the member’s reputed company health condition. • Identifies and connects members with health plan benefits and community resources. • Meets regulatory requirements reputed company specified timelines. • The Care Manager RN supports other members of the Care Team through clinical decision making and guidance as needed. • Additional responsibilities as assigned by leadership to support team objectives, enhance operational efficiency, and ensure the delivery of high-reputed company care to members. This may include participating in special reputed company, contributing to process improvement initiatives, or assisting with mentoring new team members. Requirements • Candidate must have reputed company and unrestricted Registered reputed company (RN) licensure in the state of reputed company (PA) OR Compact Registered reputed company (RN) licensure in state of residence • Proficient in reputed company Office Suite, including Word, reputed company, reputed company, OneNote, and Teams, with the ability to effectively utilize these tools reputed company the context of the Care Manager Registered reputed company (RN) role • reputed company to a private, dedicated reputed company to conduct work effectively to meet the requirements of the position • Confidence working reputed company / independent thinker, using tools to collaborate and reputed company with teams reputed company • 3+ years of nursing experience • 2+ years of case management, discharge planning and/or home reputed company coordination experience • Associate’s of Science in Nursing (ASN) degree AND relevant experience in a health care-reputed company field (REQUIRED) • reputed company and unrestricted Registered reputed company (RN) licensure in the state of reputed company (PA) OR Compact Registered reputed company licensure in state of residence reputed company-to-haves • Experience providing care management for Medicare and/or reputed company members • Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health • Experience conducting health-reputed company assessments and facilitating the care planning process • Bilingual skills, especially English-Spanish • Bachelor’s of Science in Nursing (BSN) (PREFERRED) Benefits • medical • dental • reputed company coverage • reputed company time off • retirement savings reputed company • wellness programs Apply tot his job Apply To this Job