Care Manager – Nursing

Job not on LinkedIn

November 25

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Point32Health

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 member holistically to identify needs, health goals, and barriers to wellness. • 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 ensure a safe transition to the next level of care. • Collaborate and liaise with the interdisciplinary care team to improve member outcomes. • 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 • Bachelor’s degree or relevant equivalent experience • 5 years’ relevant clinical experience • Experience in home care or case management preferred • Proficiency in a second language desirable • Experience in specialty areas a plus • Skill and proficiency in Microsoft applications, technical concepts and principles; computer software applications • Work cooperatively as a team member across multiple levels within the organization • Skilled in assessment, planning, and managing member care • Advanced communication and interpersonal skills • Independent and autonomous with key job functions • Ability to address multiple complex issues • Flexibility and adaptability to changing healthcare environment • Ability to organize and prioritize work and member needs • Demonstration of strong clinical and critical thinking skills • 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

Apply Now

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