RN Care Manager

🕒 il y a 19 jours

🍂 Massachusetts – Distant

🍂 Massachusetts – Remote

💵 $80 000 - $120 000 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

🦅 Parrain de Visa H1B

Cette entreprise a parrainé des visas H1B par le passé.

👻 Score fantôme 0%

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CareSource

Site WebLinkedInTous les Emplois

1001 - 5000 employés

Fondée en 30+ years

🏥 Santé

🛡️ Assurance

⚕️ Assurance santé

Healthcare • Insurance • Healthcare Insurance

CareSource est une entreprise de services de santé axée sur la fourniture d'assurances santé abordables et de solutions de soins de santé. Elle propose une large gamme de plans incluant Medicaid, le Marketplace et Medicare Advantage, visant les adultes à faible revenu, les familles, les enfants, les femmes enceintes, les personnes âgées et les personnes handicapées. De plus, CareSource fournit à ses membres des ressources pour le soutien COVID-19, des avantages dentaires, visuels et auditifs, ainsi que des services de pharmacie. L'entreprise met l'accent sur l'accès facile à la gestion des soins de santé via des plateformes en ligne et une application mobile.

Description

• Engage with enrollees in homes and community settings to establish complex care management relationships • Monitor, follow up, and provide clinical care management for dually eligible enrollees with complex medical, behavioral, and social needs • Integrate health services and community resources to coordinate care and improve outcomes • Liaise between healthcare providers, community resources, and enrollees • Perform Comprehensive, MDS-HC or successor Functional, Crisis, and Risk Assessments • Develop and implement care plans with enrollees and provide updates as status changes • Lead interdisciplinary care teams and collaborate with internal and external peers • Oversee utilization of long-term services and supports • Assist members with housing, transportation, food assistance, and social services • Educate members about Medicare and Medicaid benefits and available services • Educate members and families about chronic conditions, medication adherence, preventive care, healthy lifestyles, and self-management • Support preventive health strategies and gap closure • Follow up after hospitalizations and significant health events to ensure continuity and prevent readmissions • Coordinate with physicians, specialists, healthcare providers, community organizations, state agencies, and other stakeholders • Advocate for enrollee needs and preferences • Evaluate member satisfaction and monitor concerns • Conduct regular member, provider, and community-based visits • Report abuse, neglect, or exploitation as a mandated reporter • Adhere to NCQA and care management standards • Perform other job-related duties as requested

🎯 Exigences

• Associates of Science (A.S) degree in nursing from an accredited nursing program required, or Master's degree in social work or mental health counseling and independent license required • Three (3) years of experience as a Registered Nurse/BH Clinician, or one (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, or MA • Current unrestricted clinical license in the Commonwealth of Massachusetts as an RN, LCSW, LICSW, or LMHC required • Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel • Understanding of Medicare and Medicaid programs and community resources for dual-eligible beneficiaries • Strong written and verbal communication, interpersonal, customer relations, and customer service skills • Ability to manage multiple cases and priorities with attention to detail • Ability to work independently and as part of an interdisciplinary team • Awareness and sensitivity to diverse backgrounds and needs • Decision-making and problem-solving skills • Must have valid driver's license, vehicle, and verifiable insurance • Successful driver's license record check required • Annual Influenza vaccination required during Influenza season • Must reside in the assigned territory and within commutable distance to the Commonwealth of Massachusetts • Ability to travel greater than 50% of the time

🏖️ Avantages

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Reasonable accommodations for qualified individuals • Flexible hours, including possible evenings and/or weekends • Mobile work arrangement with regular travel to homes, offices, and public settings