Health Plan Care Manager

🕒 vor 27 Tagen

🦞 Maine – Remote

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💵 $86.926 - $107.379 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

👻 Geisterscore 3%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Martin's Point Health Care

Martin's Point Health Care

501 - 1000 Mitarbeiter

🛡️ Versicherung

📦 Logistik

💼 Beratung

Insurance • Logistics • Consulting

Martin's Point Health Care ist eine Organisation im Gesundheitswesen, die sich der Bereitstellung hochwertiger primärer und spezialmedizinischer Dienstleistungen für die lokalen Gemeinschaften verschrieben hat. Die Organisation legt großen Wert auf eine positive Arbeitsplatzkultur, die Anerkennung von Mitarbeiterleistungen und die Förderung von Vielfalt im Personal. Martin's Point Health Care bietet Karrieremöglichkeiten in verschiedenen Abteilungen, vom medizinischen Bereich bis hin zu Unternehmensrollen, und unterstützt das Wachstum der Mitarbeiter durch wettbewerbsfähige Vergütung, Entwicklungsprogramme und großzügige Vergünstigungen. Zudem wird das Unternehmen für seine Bemühungen um gesellschaftliche Auswirkungen anerkannt, indem es erhebliche Mittel für gemeinnützige Organisationen sammelt und das ehrenamtliche Engagement der Mitarbeiter fördert.

Beschreibung

• 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

🎯 Anforderungen

• 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

🏖️ Vorteile

• 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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