Care Manager – Nursing, Field

🔥 0 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $87.1k - $130.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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Point32Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🤝 Non-profit

🧘 Wellness

Healthcare Insurance • Non-profit • Wellness

Point32Health is a leading nonprofit health and well-being organization that provides health coverage and services for individuals at all life stages. Through its family of companies, including Harvard Pilgrim Health Care and Tufts Health Plan, Point32Health offers a variety of health plans, programs, and services encompassing medical, pharmacy, wellness, and behavioral health. Point32Health is committed to health equity and has been recognized for its inclusive practices, earning distinctions in areas such as health equity, disability inclusion, and LGBTQ+ workplace inclusion. With a focus on innovative solutions and high-quality coverage, Point32Health strives to create a better healthcare experience for its members and communities.

📋 Description

• Perform telephonic member outreach and/or face-to-face encounter utilizing key motivational interviewing skills to facilitate program enrollment. • Perform departmental assessments and evaluate members holistically to identify needs, health goals, and barriers to wellness. • Through assessment and collaboration with member/caregiver and providers, develop a member-specific plan of care, implement member-specific care manager interventions, and revise plan of care as needed. • Complete documentation in applicable platform according to departmental policy and regulatory standards. • Provide targeted health education, proactive strategies for condition management, and communication with key providers and vendors actively involved in the member’s care. • Collaborate with member/caregiver and the facility care team to coordinate a safe transition to the next level of care, which includes but is not limited to ensure understanding post-hospital discharge instructions, facilitate needed services and follow-up, and implement strategies to prevent re-admission. • Collaborates and liaises with the interdisciplinary care team, to improve member outcomes (i.e., Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness, and Behavioral Health CM). • Attending and presenting (as appropriate) high risk members at interdisciplinary rounds forum. • Maintain professional growth and development through self-directed learning activities.

🎯 Requirements

• Registered Nurse with current unrestricted license in state of residence • May be required to obtain other state licensure in states where Point32Health operates • Understand and follow the provisions of state-specific Nurse Practice Act(s) where Point32Health operates • National certification in Case Management desirable • 5 years’ relevant clinical experience • Experience in home care or case management preferred • Proficiency in a second language desirable • Skill and proficiency in Microsoft applications, technical concepts and principles; computer software applications • Skilled in assessment, planning, and managing member care • Advanced communication and interpersonal skills • Ability to address multiple complex issues • Ability to organize and prioritize work and member needs • Regard for confidential data and adherence to corporate compliance policy

🏖️ Benefits

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