Registered Nurse Care Coordinator

2 weeks ago

Canton, Ohio, United States Point32Health, Inc. Full time

About Us

Point32Health is a premier health and wellness organization dedicated to providing a personalized healthcare experience for individuals in our communities. We build upon the quality, nonprofit legacy of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, utilizing our expertise to assist individuals in achieving their personal health goals through a diverse array of health plans and resources that simplify the journey of health and wellness.

We take pride in the meaningful work we perform daily for our members, partners, colleagues, and communities. To discover more about Point32Health, click here.

Position Overview

The Care Coordinator - Nursing (RN CM) is responsible for ensuring that all members receive prompt care management across various stages, including transitions of care, care coordination, complex case management, population health initiatives, and chronic disease management in accordance with departmental protocols. The nurse care coordinator demonstrates strong clinical acumen, critical thinking abilities, and the capacity to facilitate a care plan that guarantees high-quality medical care for the member. The RN CM collaborates closely with the member, their caregiver or authorized representative, and healthcare providers to achieve specific member-centered objectives. In alignment with national care management standards, the RN CM emphasizes empowering members to promote optimal health and enhance self-management.

Key Responsibilities

  • Conduct assessments, work with the member/caregiver and healthcare providers to create a tailored care plan, implement member-specific care management strategies, and assess and adjust the care plan as necessary.
  • Facilitate program enrollment by employing effective motivational interviewing techniques.
  • Deliver targeted health education, proactive condition management strategies, and maintain communication with key providers and vendors involved in the member's care.
  • Engage in both telephonic and in-person outreach to identify barriers to wellness and assess the medical, behavioral, and psychosocial needs of the member.
  • Collaborate with the member/caregiver and the facility care team to ensure a safe transition to the next level of care, which includes clarifying post-hospital discharge instructions, facilitating necessary services and follow-ups, and implementing strategies to prevent readmission.
  • Document case information in the relevant care management system according to departmental and regulatory standards.
  • Work in partnership with the interdisciplinary care team to enhance member outcomes (including Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness, and behavioral health case management).
  • Participate in interdisciplinary rounds, presenting high-risk members as appropriate.
  • Engage in professional development through self-directed learning activities.
  • Perform additional duties and projects as assigned.

Qualifications

COVID Policy

Point32Health encourages all colleagues to adhere to CDC guidelines regarding COVID-19 vaccinations, boosters, isolation, and masking. The organization reserves the right to modify its requirements in response to COVID-19 trends in the communities served.

Education, Certification, and Licensure

  • Registered Nurse with a current unrestricted license in the state of residence.
  • May need to obtain additional state licensure in states where Point32Health operates.
  • Bachelor's Degree in Nursing is preferred.
  • National certification in Case Management is desirable.

Experience (minimum years required):

  • 5+ years of relevant clinical experience.
  • Experience in home care or case management is preferred.
  • Proficiency in a second language is desirable.
  • Experience in specialty areas such as oncology, neurology, or chronic condition management is a plus.

Skills Required

  • Proficient in technical concepts and principles; adept with computer software applications.
  • Skilled in assessment, planning, and managing member care.
  • Strong communication and interpersonal skills.
  • Ability to work independently and autonomously in key job functions.
  • Capable of addressing multiple complex issues.
  • Flexible and adaptable to the evolving healthcare landscape.
  • Ability to organize and prioritize work and member needs effectively.
  • Demonstrates strong clinical and critical thinking abilities.

Working Conditions and Additional Requirements (including special requirements, e.g., lifting, travel):

  • Must be able to work in a standard office environment and remotely as required.
  • Work may involve simultaneous use of a telephone/headset and PC/keyboard, requiring extended periods of sitting.
  • Ability to conduct in-person visits (member homes, provider practices, facilities) as necessary to meet member needs and achieve positive outcomes.
  • A valid driver's license and a vehicle in good working condition are required as some travel is necessary.
  • May be required to work additional hours beyond the standard work schedule.
  • Other duties as assigned by the department.

The above statements are intended to describe the general nature and level of work performed by employees in this classification. They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of employees in this position. Management retains the discretion to add to or modify the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are eligible for variable pay. Eligibility for any bonuses, commissions, benefits, or other forms of compensation remains at the company's discretion and may be modified accordingly.

Point32Health offers a competitive and comprehensive total rewards package, which currently includes:

  • Medical, dental, and vision coverage.
  • Retirement plans.
  • Paid time off.
  • Employer-paid life and disability insurance with additional buy-up coverage options.
  • Tuition assistance program.
  • Well-being benefits.
  • A full suite of benefits to support career development, individual and family health, and financial well-being.

For more details on our total rewards programs, visit our website.

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is dedicated to integrating diversity, equity, inclusion, accessibility, and health equity into all aspects of our operations—from product design to the workforce driving that innovation. Our DEIA and Health Equity strategy is closely aligned with our core values and will evolve as the nature of work changes. Our programming, events, and inclusion infrastructure play a crucial role in fostering cultural awareness, training leaders to engage with their teams, and establishing guidelines for recruiting and retaining talented individuals. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

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