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Care Manager, Registered Nurse
4 months ago
Job Description: Sharecare is the leading digital health company that helps people - no matter where they are in their health journey - unify and manage all their health in one place. Our comprehensive and data-driven virtual health platform is designed to help people, providers, employers, health plans, government organizations, and communities optimize individual and population-wide well-being by driving positive behavior change. Driven by our philosophy that we are all together better, at Sharecare, we are committed to supporting each individual through the lens of their personal health and making high quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com. Job Summary: The Care Manager supports the implementation of the CareFirst Value Based Care Management program by working with CareFirst members. The Care Manager partners with members, caregivers and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to improved health outcomes. The Care Manager will advocate, guide and intervene on behalf of their members to ensure successful completion of member goals, while providing Complex Case Management and strategies for health self-management through the duration of the care plan. Essential Job Functions: * Research and identify members with acute and complex health conditions. * Engage telephonically with members, caregivers, and providers to develop a comprehensive plan of care, identify key strategic interventions, and address the members needs at various stages along the care continuum. * Assess the member's ongoing care needs and progress towards goals throughout the plan duration and make revisions as needed to address changes in the member's condition, lack of progress toward goals of the care plan, preference changes, and transitions in care settings. Coordinates plan of care with goals of member stabilization, decreased admissions, medication management, behavior change and ability to self-manage. * Coordinate patient education in support of standards of care guidelines and related health issues using the most appropriate modality for the member. * Identify relevant benefit and community resources, evaluates Social determinants of Health and facilitates referrals based on member need. * Assist the member in coordination of any additional tests, images and consults with specialists. * Perform medication reconciliation at the onset of care plan, after changes in health status, and every thirty days during the life cycle of the care plan, assessing for efficacy and drug interactions/side effects. * Facilitate and monitor the transition of care which involves moving the member from one healthcare practitioner to another as their healthcare needs change. Implements and oversees the agreed upon plan of care as well as coordinates member follow-up post discharge. * Utilize established documentation standards to maintain quality of care plan documentation to include member progress toward their established state of being and barriers to achievement of care plan objectives and outcomes. * Abide by Value Based Care Management Program Description and Guidelines. * Complete mandatory training. * Actively participate in team huddles and contribute to clinical learning. * Remain current on clinical knowledge via self-directed learning. Specific Skills/ Attributes: * Ability to be self-directed, highly organized and proficient in problem solving skills. * Comfort with managing multiple tasks and continually re-prioritizing. * Ability to meet established deadlines. * Exceptional oral, written, and presentation skills. * Ability to effectively communicate and provide positive customer service to internal and external customers, meeting the expectations for service excellence. * Successfully partner with all levels of administrative and professional personnel. * Demonstrate resilience and effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads. * Success with engaging members. Outstanding customer service skills and ability to adapt approach to various personalities. * Ability to extrapolate information from a variety of sources including medical records to create concise records that accurately depict the medical "story" of the member. * Proficiency with data analysis and ability to organize data in support of reporting needs. * Ability to proactively identify and assimilate quality improvement processes into practice. * Experience with medically oriented care plan documentation. * Experience working effectively within a matrix organizational design. Qualifications: * Current multi-state compact Registered Nurse licensure in state of residence is required, with ability to obtain additional licenses without restriction. BSN preferred. * Training in motivational interviewing preferred. * Minimum 3-5 years clinical experience in any of these areas: acute care, home health, physician office management, managed care organization, provider relations, pharmaceutical sales. * Demonstrates computer competencies to include word processing, spreadsheet, presentation preparation, and database management. Demonstrated ability to learn customized computer applications. * Maximize all technology inclusive of Microsoft Teams, Microsoft Word, Microsoft Excel, Microsoft Outlook, laptop computers, and all other relevant unified communication technologies. * This position will be based from a home office which must satisfy all HIPAA requirements. Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. Sharecare, Inc. and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law. Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Qualified applicants will receive consideration for employment without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, equal pay, disability, genetic information, protected veteran status, or other status protected under applicable law.
