RN Care Manager

3 weeks ago


Melbourne, Florida, United States Christian Care Ministry Full time
About the Role

The RN Care Manager serves as the key point of contact and coordinator of care to members experiencing an acute, catastrophic, or costly health care event.

Key Responsibilities
  • Performs within licensed scope of nursing practice and under the direction of the Sr. Director, Clinical Services
  • Identifies, screens, and enrolls members meeting criteria into Care Management Services
  • Educates members and providers (as appropriate) regarding the Medi-Share provisions and processes
  • Confirms member's condition and plan of care are eligible for sharing based on Medi-Share and FDA/CMS approved evidence-based clinical management guidelines; suggests resources for those conditions/plan of care not eligible for sharing
  • Identifies, educates, and facilitates member participation in appropriate member stewardship including, but not limited to patient assistance programs for medication, laboratory, and genetic testing
  • Provides disease/condition specific clinical education to include multimedia resources, if available
  • Identifies opportunities for and facilitates transitional care
  • Partners with organizational resources to facilitate effective and cost-efficient outcomes for members
  • Delivers accurate and comprehensible verbal and written communication to external customers while complying with organizational HIPAA requirements
  • Documents case work, all telephone conversations, correspondence, and tasks completely and accurately in appropriate IT systems
  • Maintains and independently manages assigned caseload and departmental workflows within agreed service levels
  • Presents accurate, complete, and concise case information to Sr. Director, Clinical Services within agreed upon service levels
  • Completes medically related special projects independently as assigned with minimal supervision
  • Attends all required departmental and organizational meetings
  • Prays with members and providers as appropriate
  • Contributes to the exercise and expression of the Ministry's Christian beliefs
Requirements
  • Registered nurse with a current unrestricted multi-state compact license or willingness to pursue
  • Bachelor of Science in Nursing (strongly preferred) or health-related field (required)
  • Cardiovascular, Medical/surgical, orthopedic, pediatrics, and/or transplant clinical experience required
  • 3+ years nursing experience required; acute and catastrophic care highly preferred
  • 2+ years of case management and/or utilization management and discharge planning experience
  • Have or willing to obtain a certification in either case management or managed care nursing within two years
Benefits

We offer a comprehensive benefits package, including annual incentive pay, 100% paid Medical for employees/99% for family, generous employer Health Savings Account (HSA) contributions, and more.



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