Health Plan Care Manager

🕒 Setembro 3

🦞 Maine – Remoto

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💵 $86.926 - $107.379 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 3%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Martin's Point Health Care

Martin's Point Health Care

501 - 1000 funcionários

🛡️ Seguros

📦 Logística

💼 Consultoria

Insurance • Logistics • Consulting

A Martin's Point Health Care é uma organização de saúde comprometida em servir suas comunidades locais com serviços de cuidados primários e especializados de alta qualidade. A organização dá ênfase à criação de uma cultura de trabalho positiva, reconhecendo as contribuições dos funcionários e promovendo a diversidade no local de trabalho. A Martin's Point Health Care oferece uma variedade de oportunidades de carreira em diversos departamentos, desde prestadores de serviços de saúde até funções corporativas, e apoia o crescimento dos funcionários por meio de uma remuneração competitiva, programas de desenvolvimento e benefícios generosos. Além disso, a empresa é reconhecida por seus esforços de impacto comunitário, arrecadando fundos significativos para organizações comunitárias e incentivando o voluntariado dos funcionários.

Descrição

• Provide comprehensive, person-centered care management interventions for enrolled members and families • Engage, assess, monitor, educate, coordinate, and provide interventions to improve care quality and health outcomes • Reduce unnecessary health care utilization and hospital utilization • Complete comprehensive advanced-level nursing assessments, including focused physical examinations • Apply evidence-based standards, criteria, and HEDIS quality measures • Manage care within benefits structures and compliance, contractual, and accreditation regulations • Complete timely member assessments, screenings, care transition assessments, encounters, and follow-up • Document assessments, encounters, and activities in the case management medical record • Collaborate with primary care providers, specialists, medical directors, hospitals, skilled nursing facilities, home health providers, community agencies, members, families, and caregivers • Address medical, health, social, psychological, environmental, and lifestyle issues • Develop and present case studies; participate in clinical rounds, in-services, staff education, and training • Demonstrate respectful, professional, ethical conduct and excellent customer service • Assist with process improvements and quality initiatives • Provide project support and complete additional assignments as required

🎯 Requisitos

• Bachelor’s degree in nursing required • 5 years of current clinical experience • Experience in medical-surgical, home care, hospice, community health, rehabilitation, long term care, cardiovascular, diabetes, renal, pulmonary diseases, oncology, or geriatrics • Experience in a managed care, home health, or hospital environment • Unrestricted state licensed registered nurse license required • Knowledge of Scope of Nursing Practice in states where licensed • Current clinical knowledge in chronic diseases, heart disease, COPD, diabetes, renal disease, and other co-morbidities • Must be a self-initiator with high energy/productivity and a strong work ethic • Proven history as a team player • Flexibility and adaptability in managing multiple priorities and changing schedules • Excellent written and verbal communication skills • Excellent organizational and time management skills • Must verify U.S. citizenship • Must complete employment eligibility verification upon hire • This position is not eligible for immigration sponsorship

🏖️ Benefícios

• Medical insurance • Dental insurance • Vision insurance • Retirement savings with employer contributions • Paid time off • Volunteer time off • Pie day • Other employee benefits

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