Care Manager

4 weeks ago


Nelson, Wisconsin, United States Managed Health Services Wisconsin Full time
Job Title: Care Manager

Join our team at Managed Health Services Wisconsin as a Care Manager, where you will play a vital role in transforming the health of our communities, one person at a time.

About the Role:

We are seeking a skilled and compassionate Care Manager to join our team. As a Care Manager, you will be responsible for developing, assessing, and facilitating complex care management activities for our members. Your primary goal will be to provide high-quality, cost-effective healthcare outcomes, including personalized care plans and education for our members and their families.

Key Responsibilities:
  • Evaluate the needs of our members, identify barriers to accessing care, and recommend and/or facilitate plans for the best possible outcomes.
  • Develop ongoing care plans and collaborate with providers to identify resources and specialists to address our members' unmet needs.
  • Identify problems and provide care management interventions to ensure our members receive adequate and appropriate care.
  • Coordinate between members, caregivers, and care providers to ensure person-centered care and services.
  • Provide ongoing follow-up and monitoring of member status, progress towards care plan goals, and revise or update care plans as necessary.
  • Support members and care managers with local resources for various services, such as employment, housing, and independent living.
  • Facilitate care management and collaborate with providers to ensure timely access to needed care or services.
  • Perform telephonic, digital, home, and/or other site outreach to assess member needs and collaborate with resources.
  • Collect, document, and maintain all member information and care management activities to ensure compliance with state, federal, and third-party payer regulators.
  • Provide education to members and their families on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits.
  • Provide feedback to leadership on opportunities to improve and enhance care and quality delivery for our members in a cost-effective manner.
Requirements:
  • Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience.
  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required.
What We Offer:

We offer a comprehensive benefits package, including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field, or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

We are an equal opportunity employer that is committed to diversity and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


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