Role Description
The Nurse Care Manager I is responsible for collaborating with health plan beneficiaries and/or providers to drive personalized health management and improve health outcomes for consumers.
Location: Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.
Schedule: 9:00-6:00pm PST
• Candidates should reside in compact license states*
How you will make an impact:
• Provide quality case management to health plan beneficiaries to assess, plan, and support improvement in member’s functioning and health outcomes.
• Conduct clinical assessment to develop goals that address individual needs in order to develop a care plan; implements and coordinates a care plan.
• Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Assists with development of case management policies and procedures.
• Assists members in identifying appropriate medical needs, ensuring access to resources and services, address social determinants of health, and facilitate safe care transitions.
• Coordinate with internal and external partners to collaborate on members’ care.
• May be required to obtain licenses in multiple states to better support members across the country.
Qualifications
• Requires a HS diploma or equivalent and a minimum of 3 years of acute care clinical experience, condition specific clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current, unrestricted RN license in applicable state(s) required. Multi-state licensure is required if this individual is providing services in multiple states.
Requirements
• AS or BS in nursing preferred.
• Certification as a Case Manager is preferred.
• Home health/discharge planning experience preferred.
• Bilingual Spanish preferred.
• NICU and high-risk OB experience preferred.
Benefits
• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).