Job Description

This is a remote position.

As an RN Care Manager you will engage with members either facetoface in community settings or telephonically to conduct comprehensive assessments and collaboratively develop care plans. Your role involves utilizing motivational interviewing active listening and problemsolving skills to support members in achieving their healthcare goals. You will identify urgent situations educate members on health and wellness and connect them with relevant community resources. This position requires excellent documentation and technical skills to navigate various computer applications.

Primary Responsibilities:

• Engage members in community settings or telephonically.
  
• Conduct comprehensive member assessments including biopsychosocial functional and behavioral health needs.
  
• Utilize motivational interviewing to help members identify and achieve their intrinsic goals.
  
• Use active listening to gather and retain member information during assessments.
  
• Collaboratively develop individualized care plans with members.
  
• Identify and escalate urgent member situations as necessary.
  
• Assist members in setting healthcare goals and overcoming barriers to achieving these goals.
  
• Educate members on health and wellness to aid in selfmanagement.
  
• Connect members with relevant community resources.
  
• Present complex cases to an interdisciplinary care team for input and guidance.
  
• Use computer applications (e.g. Excel Word Outlook) to summarize and communicate member information.
  
• Document assessments interactions referrals and followup plans in relevant systems.
  
• Stay updated on changes to computer systems and apply this knowledge effectively.
  
• Achieve performance goals within a virtual environment.
  

Required Qualifications:

• Must reside in the Philadelphia PA region.
  
• Bachelor s degree or an Associate degree with RN license.
  
• Unrestricted license as a Registered Nurse in the state of PA.
  
• 4 years of experience in Case Management and/or Care Coordination.
  
• Experience managing populations with complex medical or behavioral health needs.
  
• Proficient in Microsoft products including Excel and Outlook; quick learner of clinical applications.
  
• Designated workspace and secure highspeed internet via cable/DSL at home.
  
• Current driver s license auto insurance and ability to travel for occasional field visits.
  
• Strong passion for helping members with complex needs.
  

Preferred Qualifications:

• Background in Managed Care.
  
• Certified Case Manager (CCM) certification.
  
• Bilingual capabilities a plus.
  
• Experience in utilization review concurrent review and/or risk management.
  

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