Clinical – Care Manager (RN) Care Manager (RN) Position Available In [Unknown county], South Carolina

Clinical

• Care Manager (RN) Care Manager (RN)#25-55841
  Various, SC
  All On-site Job Description

Job Description:

Position Purpose:

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

Education/Experience:

Requires a Degree from an Accredited School of Nursing or a Bachelor’s degree in Nursing and 2

• 4 years of related experience.

License/Certification:

RN

• Registered Nurse
• State Licensure and/or Compact State Licensure requiredEvaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member’s unmet needs Identifies problems/barriers to care and provide appropriate care management interventions Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member’s goals / unmet needs Provides resource support to members and care managers for local resources for various services (e.

g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner Other duties or responsibilities as assigned by people leader to meet business needs
Performs other duties as assigned Complies with all policies and standards
Comments for

Vendors:

There will be no overtime granted for these positions.

• bill rate
• May need to travel 25% of the time.

EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of

• Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” ========
  Centene Job Description Story Behind the Need
• Business Group & Key Projects Health plan or business unit
  Team culture
  Surrounding team & key projects
  Purpose of this team
  Reason for the request
  Motivators for this need
  Any additional upcoming hiring needs? Absolute Total Care
  Hard working and communicates well amongst the team for to ensure end goals being met
  N/A
• Replacement for temp, Lesley Perry

Position Purpose:

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families. Typical Day in the Role Daily schedule & OT expectations
Typical task breakdown and rhythm
Interaction level with team
Work environment description

SEE ABOVE FOR SCHEDULE

To complete care assessment after a hospitalization and provide case management services as needed to members; telephonic outreaches to facilities and members; Assist facility staff with discharge planning efforts for members.

• N/A
  Daily engagement via emails and chats to ensure end goals/metrics are met
  Compelling Story & Candidate Value Proposition What makes this role interesting?

Points about team culture
Competitive market comparison
Unique selling points
Value added or experience gained This person will working remote and may also need to travel to see members.
Works closely together and willing to help when needed to meet attained metrics
N/A
N/A Candidate Requirements
Education/Certification

Required:

Bachelor’s Degree, Licensed

Preferred:

Master’s Degree
Licensure

Required:

Licensed Health Provider

Preferred:

2+ years as a licensed health provider Years of experience required
Disqualifiers
Best vs. average
Performance indicators Must haves: Must have the licensed requirements sent in, Must reside in SC.

Nice to haves:

Case Management experience,

BSN Disqualifiers:

Performance indicators: Outreaches to members after discharge from hospitalizations w/in 10 business days after discharge Best vs.

average:

Top 3 must-have hard skills
Level of experience with each
Stack-ranked by importance
Candidate Review & Selection 1 2+ years nursing experience
2 Commitment
3 Great computer skills and knowledge of navigating systems 4 MS Office

• Outlook, Word, Excel, Teams