Address
Form of workResponsibilities:
The Care Manager assists members appropriate for care coordination and case management services in achieving their optimal level of health. The Care Manager is responsible for engaging the member and providers to assess, plan and establish individual member goals. Will facilitate and coordinate care for the members while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members in the care coordination program. Assess members to determine care coordination and case management needs for all referred members. Completes comprehensive assessment of environmental, Psycho-social and support needs. Identifies problems/barriers for care coordination and appropriate care management interventions. Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health. Identifies both short and long term goals and associated time frames for completion. Shares goals with the member and family as appropriate. Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress. Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems. Coordinates care and services with the Account manager, Complex RN Case Manager, and member, family members as appropriate, PCP, Specialist, and Facility/Vendor Providers
Education/Experience:
The Care Manager assists members appropriate for care coordination and case management services in achieving their optimal level of health. The Care Manager is responsible for engaging the member and providers to assess, plan and establish individual member goals. Will facilitate and coordinate care for the members while assuring quality and use of cost-effective resources. The position will function as a single point of contact and be an advocate for members in the care coordination program. Assess members to determine care coordination and case management needs for all referred members. Completes comprehensive assessment of environmental, Psycho-social and support needs. Identifies problems/barriers for care coordination and appropriate care management interventions. Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health. Identifies both short and long term goals and associated time frames for completion. Shares goals with the member and family as appropriate. Identifies and implements the appropriate level of intervention based upon the member's needs and clinical progress. Schedules follow up calls as necessary, makes appropriate referrals. Implements actions to address member issues. Documents progress towards meeting goals and resolving problems. Coordinates care and services with the Account manager, Complex RN Case Manager, and member, family members as appropriate, PCP, Specialist, and Facility/Vendor Providers
Education/Experience:
- While this is a remote role, qualified candidates must reside in the PeeDee and Midlands regions of SC.
- This position requires the selected candidate to meet with identified members face to face in the community, as needed.
- The hours of this position are Monday through Friday from 8:30a to 5:00p EST.
- Bachelor of Science in Nursing (BSN) required.
- Current and unrestricted Registered Nurse license in South Carolina (or compact state).
- 3 years of professional practice experience in pediatric home care and/or acute care required.
- Experience working with the Foster Care System, Department of Social Services, or Department of Juvenile Justice as a RN preferred.
- 3 years of case management experience preferred.
- Proficiency using MS Office (Word, Excel, Outlook, Teams), internet applications, and electronic medical record and documentation programs.
- Valid driver's license with car insurance.
