Care Manager RN

3 weeks ago


Oklahoma City, Oklahoma, United States GLOBALHEALTH HOLDINGS LLC Full time
Job Title: Care Manager RN

Join GlobalHealth Holdings LLC as a Care Manager RN and play a vital role in improving the long-term wellness of our members.

About the Role:

This position, under the direction of the Supervisor, Care Management, performs and manages all aspects of care management to improve the long-term wellness of members, becoming an advocate for our members through coordination of care.

Key Responsibilities:
  • Conducts telephonic case management for complex, high-risk members to include identification and assessment of needs, planning and coordination of care, and monitoring outcomes in accordance with GlobalHealth and the departments policies and procedures.
  • Coordinates with providers when applicable to ensure holistic, healthy, beneficial outcomes.
  • Communicates with respect to family culture, ethnic origin, race, language, gender, age, religion, socioeconomic status, sexual orientation, mental and/or physical challenges.
  • Through interdepartmental communication, network communication, and member outreach the Case Manager remains aware of patient needs and changes in condition, providing patient advocacy, support, assessing and ensuring quality care, and providing crisis intervention.
  • Coordination of services for members, including community resources and collaboration with other members of the care team.
  • Educate members and their caregivers on conditions and self-management techniques.
  • Initiate and participate in all elements of the SNP MOC, including completing HRA, creating ICP, and initiating ICT.
  • Complete TOC activities to include post-discharge assessment, medication reconciliation/review, and ensuring member has access to follow up care.
Requirements:
  • Active Registered Nurse license in the state of Oklahoma required
  • Active multi-state RN license is preferred
  • Previous experience in managed care/utilization management preferred
Work Environment:

Work is normally performed in a professional setting. Work involves standing and walking for brief periods of time, but most duties are performed from a seated position. Work may include occasional pushing and/or pulling, lifting, and carrying objects weighing up to 20 pounds. Work requires normal vision and hearing as might be required in typical conversational use along with finger dexterity and eye-hand coordination to operate a computer keyboard at a moderate skill level.

 


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