resident care manager rn

TEEMA Group

<div>Job Title: Registered Nurse (RN) Disease Manager
Job Overview: 
The Registered Nurse (RN) Disease Manager is responsible for coordinating care and managing the health outcomes of patients with chronic or complex health conditions. This role involves assessing, monitoring, educating, and supporting patients in managing their diseases to improve overall health and quality of life while reducing unnecessary hospitalizations and emergency care.
Key Responsibilities:<ul><li>
Patient Assessment: Conduct comprehensive assessments of patients&rsquo; physical, emotional, and psychosocial needs related to their chronic conditions.</li><li>
Care Coordination: Work closely with interdisciplinary teams, including physicians, case managers, social workers, and other healthcare professionals, to develop and implement individualized care plans for patients.</li><li>
Disease Education: Provide education to patients and their families regarding their diagnoses, treatment plans, and self-management techniques to improve disease outcomes.</li><li>
Case Management: Monitor patient progress and adjust care plans as necessary. Ensure that patients are following their prescribed treatment and managing their conditions effectively.</li><li>
Data Management and Reporting: Track patient outcomes and document interactions accurately. Utilize health information technology to document care, track patient progress, and report to appropriate stakeholders.</li><li>
Advocacy: Advocate for the patient&rsquo;s needs, including obtaining necessary resources or services that will improve their health outcomes.</li><li>
Prevention and Health Promotion: Promote preventive care, including vaccinations, screenings, and lifestyle modifications to reduce the impact of chronic conditions.</li><li>
Collaboration with Providers: Maintain communication with healthcare providers to ensure continuity of care, timely follow-ups, and updates on patient status.</li></ul>
Qualifications:<ul><li>
Education: Bachelor&rsquo;s Degree in Nursing (BSN) or an Associate's Degree in Nursing (ADN) with appropriate certifications.</li><li>
Licensure: Current Registered Nurse (RN) license in the state of employment.</li><li>
Experience: 3-5 years of clinical nursing experience, preferably in disease management, case management, or a related field.</li><li>
Certifications: Certification in Disease Management (CDM), Case Management (CCM), or other relevant certifications preferred.</li><li>
Skills: Strong communication, problem-solving, and critical thinking skills. Ability to work independently and as part of a team. Proficiency with electronic health records (EHR) and other healthcare technology.</li></ul>
#Workwolf</div>

RN Case Manager – Managed Care REMOTE

Rochester Regional Health

<div>Job Title: RN Care Manager 
Department: Greater Rochester Independent Practice Association (GRIPA) 
Location: 100 Kings Highway South, Rochester, NY 
Hours Per Week: 40 hours 
Schedule: Full-time, Days 
 
This position will be employed by the Greater Rochester Independent Practice Association, INC. (GRIPA). GRIPA was founded in 1996 as a unique collaboration between hospitals and physicians, for the purpose of simultaneously improving the quality and efficiency of health care. This position will not be employed by Rochester Regional Health (RRH). 
SUMMARY
As a Registered Nurse &ndash; Care Manager, your excellent interpersonal, leadership and collaboration skills ensure the appropriate allocation of hospital resources while maintaining the quality of care. Actively participates in the utilization management process using standards of care to determine the most appropriate level of care, participating in the development of plans for care, managing the care across the continuum to ensure a safe discharge in a timely manner.
RESPONSIBILITIES<ul><li>
Evaluation &amp; Review. Evaluate hospital admissions to assure care is medically necessary and delivered at the most appropriate level; actively participate in the concurrent review process and communicate/intervene with third party payors to ensure reimbursement for services are provided while maintaining quality of care
</li><li>Patient Management. Collaborate with providers, patients and families to address concerns and identify safe, effective discharge plans; intervene to identify and facilitate early referral for discharge planning; facilitate the discharge process by working with the healthcare team to identify alternative solutions to minimize system delays while ensuring a safe discharge plan</li><li>
Recommendation. Coordinate and participate in the development, implementation and revisions of evidence based clinical pathways and guidelines; participate in driving clinical and administrative compliance with care guidelines and core measures; identify and recommend actions for improvement</li></ul>
REQUIRED QUALIFICATIONS<ul><li>
Associate&rsquo;s Degree in Nursing (ASN)</li><li>
Registered Nurse with current New York State License</li><li>
AHA BLS</li></ul>
PREFERRED QUALIFICATIONS<ul><li>
Bachelors in Nursing (BSN)</li><li>
Three (3) years of acute hospital care, case management or utilization management experience</li><li>
Case Management Certification</li><li>
Excellent oral and written communication and interpersonal skills</li><li>
Good understanding of medical management techniques and processes</li><li>
Knowledge of federal and state regulations (DOH, Medicaid/Medicare)</li><li>
Strong organizational and problem-solving skills</li><li>
Knowledge of third party payor and/or managed care payment principles helpful</li></ul>
EDUCATION:
LICENSES / CERTIFICATIONS:
BLS - Basic Life Support - American Heart Association (AHA)American Heart Association (AHA), RN - Registered Nurse - New York State Education Department (NYSED)New York State Education Department (NYSED)
PHYSICAL REQUIREMENTS:
M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting.
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.
Any physical requirements reported by a prospective employee and/or employee&rsquo;s physician or delegate will be considered for accommodations.
PAY RANGE:
$80,750.00 - $110,290.00<div><div><div><div><div><div><div>
CITY:</div></div></div></div></div></div></div>
Rochester<div><div><div><div><div><div><div>
POSTAL CODE:</div></div></div></div></div></div></div>
14617
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.
Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.</div>

Care Manager-RN

NorthLakes Community Clinic

<div><h1 class="jobSectionHeader">Caring for our community starts with you. Join a team that believes everyone deserves care.</h1>
Candidates must reside within NorthLakes' service area at the time of hire and maintain residency throughout employment.
To engage teams and patients in the delivery of evidence-based, patient-centered, lifelong care. 
 
Salary begins at $29.95 + per hour depending on experience.
The RN Care Manager will manage high risk and chronic illness to promote whole-person, integrated, quality care. The RN Care Manager will employ a person-centered and team approach, partnering with patients and their family/caregiver(s), clinic/hospital/providers and specialty providers and other staff, and community resources.<ul><li>
Conduct in-office patient visits as outlined in care plan and based on patient&rsquo;s health status and self-management interests</li><li>
Create and promote engagement with a care plan, developed with the patient, primary care provider and/or specialty care provider and family/caregiver(s)</li><li>
Support the delivery of integrated, whole-person care in family medicine, recovery and psychiatric care.</li><li>
Engage patients in self-management and shared decision-making</li><li>
Increase utilization of preventative care services</li><li>
Promote timely access to appropriate care to reduce emergency room utilization and hospital readmissions</li><li>
Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals</li><li>
Work with internal providers on coordinating schedules, getting a client in to other service lines as needed</li><li>
Facilitate patient access to appropriate medical and specialty providers, assisting with residential and detox referrals</li><li>
Assist with the identification of &ldquo;high-risk&rdquo; patients with a chronic illness and those with special health care needs, coordinate care, and track outcomes</li><li>
Assess for social drivers of health and work with Community Health Workers on integrated Care Management</li><li>
Attend all Care Management training courses/webinars and meetings &ndash; contribute to the development of the Care Management Program</li><li>
Participate in quality improvement efforts by; utilizing dashboards, tracking tools and providing quality reporting data monthly</li><li>
Follow protocols, clinical policy and procedure in collaboration with the Primary Care Provider/Specialty Care provider for chronic care management. Follows clinical guidelines protocols and policies related to all direct patient care.</li><li>
Performs in-clinic triage and medication refills</li><li>
Work with Triage Nurse team as needed to perform medication refills and triage.</li><li>
Conducts nursing assessments according to assessment tools to determine services and service level of care needed.</li><li>
Under provider direction performs and/or assists provider in inductions utilizing COWS, administers patient injections and provides education on naloxone.</li><li>
Helps monitor OB clients, talking with their OB provider about pain management for delivery and postpartum.</li><li>
Provides education about Neonatal Abstinence syndrome, support systems, and concerns</li><li>
General Education with patients about substance use, tobacco cessation, prevention, communicable disease management, new medical diagnosis</li><li>
Monitor medication adherence, including checking the PDMP, help monitor side effects, provide patient education, assist prior authorizations and prescription assistance programs</li><li>
Provide medication reconciliation and complete refill requests, including for controlled substances under direction and approval from prescribing provider</li><li>
Connect patients to relevant community resources, with the goal of enhancing patient health and well-being, increasing patient satisfaction, and reducing health care cost
</li><li>Serve as the contact point, advocate, and informational resource for patients, care team, family/caregiver(s), payers, and community resources</li><li>
Facilitate and attend meetings between patient, family/caregiver(s), care team, and community resources, as needed</li></ul><div>
Qualifications and Education Requirements</div><div><ul><li>
Minimum Level of Completed Education: Associates Degree in Nursing</li><li>
Prior years of experience in similar role: RN with two+ years related experience and/or training</li><li>
Experience with systems, computer applications/software: Electronic Health Records, preferably Epic.</li><li>
Required (or Preferred) Licensure/Cert/Credentials: Current, valid and unrestricted WI license to practice as a Registered Nurse. Current CPR certification required.</li><li>
Evidence of leadership, communication, education and counseling skills. Local knowledge about community health care and social welfare resources preferred.</li></ul>
Benefit Statement
For full time and part time employees who work 24 or more hours per week we offer a generous benefits package that includes:<ul><li>Medical and dental insurance</li><li>Employer paid group term life and disability</li><li>Employer contribution toward Health Savings Account</li><li>Flexible Spending Accounts</li><li>Paid Time Off (PTO), Paid Holidays and Paid Leave Bank</li><li>403(b) with a 4% employer match</li></ul>
Various voluntary benefits:<ul><li>Vision Insurance</li><li>Supplemental Life, AD&amp;D and Disability</li><li>Tuition reimbursement</li><li>Health and Wellness reimbursement program</li><li>Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members</li><li>Partner of HRSA/NHSC loan repayment program</li></ul>
Our Mission is to respond to the healthcare needs of our communities with an integrated array of quality services and actively remove barriers to wellness.
NorthLakes Community Clinic is an Equal Opportunity Employer. All qualified applicants will be considered for employment regardless of age, race, color, creed, religion, sex, sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
All offers of employment are contingent upon successful completion of a criminal background check and references.</div>
At NorthLakes Community Clinic, our organizational competencies highlight the behaviors and values that guide how we work and provide a shared foundation for performance, development, and growth throughout an employee&rsquo;s career with us.
NorthLakes Community Clinic Organizational Competencies
Mission Driven - Advances the organizational mission, vision and values in executing job duties.
Customer Service - Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met.
Quality - Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
Creativity - Generates new ideas, supports change, provides innovative solutions, solves problems creatively.
Integrity - Earns the trust and confidence of coworkers and customers through honest communication, ethical behavior and professionalism in all interactions.
Teamwork - Contributes to meeting team deadlines and responsibilities, listens to others and values opinions, helps team to meet goals, welcomes newcomers and promotes a cooperative team atmosphere.
Self-Development - Seeks out and accepts feedback, is a proactive learner, takes on tough assignments to improve skills, keeps knowledge and skills up-to-date, turns mistakes into learning opportunities.
Job Knowledge - Understands duties and responsibilities, possesses necessary job knowledge and technical skills, maintains job knowledge current.
Communication - Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills.
Dependability - Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.
Trauma/Resilience Informed - Understands that trauma is prevalent and resilience can be cultivated and improved; and operates in a manner consistent with these principles.</div>

RN Care Manager

Citizens Memorial Healthcare

<div><div><div>Citizens Memorial Hospital (CMH) is recruiting a Complex Care Manager to care for our patients in the Oncology Clinic! CMH is made up of 34 primary and specialty clinics, 6 Long-Term Care facilities and 1 residential care facility. Offering acute care, emergency services, ambulatory care, pharmacies, walk-in clinics, surgeries, addiction recovery, therapies and more, CMH has its community covered!
About the area: Located in the heart of the Ozarks, our main campus in Bolivar has a hometown feel and affordable housing options of rentals or apartments. Enjoy a movie, a round of golf or a college game with family or friends and grab a coffee or meal from an array of shops and restaurants! Springfield is only 40 minutes away with Battlefield Mall, Big Shots golf, Wonders of Wildlife, Urban Air and many other family attractions and restaurants to visit. Only an hour away is Branson that includes many shows to see, Silver Dollar City and shopping!
About the department: The Oncology Clinic supports patients living with chronic and serious illness by providing proactive symptom assessment, advance care planning support, and coordinated communication between patients, families, and providers. The Clinic Palliative Care Nurse promotes patient-centered goals of care, reduces unnecessary hospital utilization, and ensures smooth transitions between palliative care services and chronic care management.
 A typical day includes:
<ul><li>Providing specialized nursing care, education, and goalsofcare conversations while preparing accurate, compliant documentation for all encounters.</li>
<li>Coordinating closely with providers, social workers, care managers, and clinic teams to address patient needs, manage transitions, and connect patients with appropriate resources.</li>
<li>Delivering comprehensive patient assessments and ongoing symptom checkins, documenting needs across physical, emotional, cultural, spiritual, and social domains.</li>
</ul>
The position is full-time, days.
Job Requirements:
<ul><li>Education: Associate's degree or Bachelor's degree; Palliative Care Certification, or willingness to obtain</li>
<li>Skills: Strong communication skills related to serious illness conversations.</li>
<li>Experience: Minimum of two (2) years of experience in nursing practice desired</li>
<li>License: RN or LPN</li>
<li>Physical: The ability to thrive in a fast-paced environment</li>
</ul>
Benefits include:
<ul><li>Competitive wages</li>
<li>Annual merit increases</li>
<li>No cost health insurance option for employee</li>
<li>Full suite of insurance benefits available for employee and family</li>
<li>Early access to pay with on-demand PayActiv Program</li>
<li>Employee Assistance Program</li>
<li>Paid time off</li>
<li>Increased Company Matched Retirement Plan</li>
<li>Company paid long term disability plan</li>
</ul>
Connect with us! See yourself at CMH and join in the fun: https://www.facebook.com/CMHRecruiting
For more information about this opportunity, please contact Cyndi McDaniel at 417-328-6793 or by email at Cynthia.mcdaniel@citizensmemorial.com.</div> 
</div> 
Location: Citizens Memorial &middot; Oncology Clinic 
Schedule: Full Time, Days</div>

Complex Care Manager I RN or LPN

Bayhealth

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: Sussex Campus Hospital, Milford Delaware
Status: Full Time 80 Hours
Shift: Days
SALARY RANGE: 37.98 - 58.87HOURLY 
 
General Summary:
An RN who coordinates care and services of selected patient populations across the continuum of illness promoting effective utilization and monitoring of health care resources. Performs concurrent and retrospective patient reviews based on accepted quality, utilization, clinical risk and infection control criteria and communicates effectively with all members of the health care team regarding issues identified. 
 
Responsibilities:
1. Applies utilization management criteria for the review process, distinguishing levels of care and interacting with Physicians, other healthcare team member, and outside agencies.
 
2. Conducts patient screening for assessment of discharge planning interventions. Conducts simple discharges which include home health care, durable medical equipment, and authorizations pharmaceuticals. Provides communication to the Social Worker for complex discharge needs.
 
3. On a concurrent basis, assesses the appropriateness of the level of care; diagnostic testing and clinical procedures; performance and clinical risk issues; and documentation of medical record completeness and reports all variances and events.
 
4. Accurately and completely records all required clinical data in the data base to include information for reconsideration letters for denial of days and/or service.
 
5. Demonstrates ability to perform the Medicare denial process.
 
6. Recognizes urgent utilization issues and reports them to the Care Management manager, unit management, and attending physician immediately
 
7. All other duties as assigned within the scope and range of job responsibilities
 
8. ED Care Managers ONLY: Through an interdisciplinary team of health care providers, the care manager in collaboration with the physician will assist in coordinating a comprehensive plan of care using a concurrent integrated review process to determine medical necessity for appropriateness of admission. If admission is not appropriate then assist in a collaborative effort with the patient and significant other to enhance quality of care and focus on appropriateness of outpatient resource use.
 
9. Responsible, in coordination with the physician in developing and reviewing the individualized care plan, therefore assisting with the implementation of the plan of care. Communicate the plan of care with the entire health care team members. Facilitates the efficient delivery of care.
 
10. Assists the physicians with documentation compliance according to Medicare, Medicaid and Commercial payer regulations and guidelines.
 
11. Demonstrates ability to combine medical staff practice patterns, disease trajectory, community resource knowledge, and patient family desires into the critical thinking of discharge planning. Acts collaboratively with the emergency room navigator to coordinate discharge plans and arrangements for patient / families by ensuring a smooth transition from an emergency room level of care to another as required.
 
12. Conducts the initial assessment for the identification of potential discharge needs and provides communication to the Social Service Inpatient Discharge Planners.
 
13. Non-ED ONLY: Performs concurrent denial recovery of all denied days and records outcomes in the clinical data base. Requests sub-acute level of care when applicable to denied days.
 
14. Acts collaboratively with Social Services for post-hospital care needs 
 
 
Required Education, Credential(s) and Experience:
<ul><li>Education: Bachelor Degree
 
; Nursing
 
;
 
</li><li>Credential(s): Registered Nurse
 
Basic Life Support
 
; 
 
 
</li><li>Experience: Required: 5 years nursing experience within the last 10 years Preferred: Utilization Review, Care/Case Management experience
</li></ul>Preferred Education, Credential(s) and Experience:
<ul><li>Education:
</li><li>Credential(s): Certified Case Manager
 
Certified Professional in Utilization Review 
 
 
 
</li><li>Experience:
</li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

CircleLink Health

<div>This is a remote role. CircleLink Health is looking for passionate, tech savvy ILLINOIS registered nurses to work remotely and serve patients enrolled in Medicare&rsquo;s Chronic Care Management Program. In this part time role (requires about 20 to 25 hours per week, depending on caseload), an RN Care Coach will be assigned a group of patients that they will be following and calling each month. In these monthly calls the Care Coach will provide education, coordinate care, close preventive care gaps, and coach on strategies for self-management to keep patients out of the hospital.
This Role Requires Precision, Discipline, and Accountability
The Care Manager role is not a step back from bedside nursing &mdash; it&rsquo;s a step into a more complex, structured, and performance-driven environment. To succeed, you must bring more than clinical knowledge:
✅ Excellent documentation skills &mdash; Your charting must be complete, timely, and accurate.
✅ Strong time management &mdash; Case tasks must be prioritized and closed on schedule.
✅ Ownership of outcomes &mdash; Each case is closely tracked for quality, compliance, and effectiveness.
Expectations are high, and performance is regularly reviewed. This is not a role where details can be missed or timelines pushed &mdash; we need professionals who take initiative, stay organized, and consistently deliver.
If you&rsquo;re ready for a challenging, fast-paced environment where your work is held to high standards and makes a real difference, we encourage you to apply.
Key Responsibilities:<ul><li>
Utilize our specialized care management software to call a full caseload of Medicare patients with two or more chronic conditions (Diabetes, CHF, Chronic Pain, COPD, etc.) on a monthly basis</li><li>
Build and maintain rapport with patients to help coach them to improved health through SMART goals and education on self-management strategies</li><li>
Implement and improve the Plan of Care by updating medications, appointments due, biometrics, symptoms, and interventions made</li><li>
Connect the patient with community resources as needed, including transportation, personal care needs, prescription/DME assistance, social services, etc.</li><li>
Conduct Transitional Care Management activities to high-risk patients discharged from the hospital and the ER to reduce unnecessary readmissions.</li><li>
Close care gaps by encouraging preventive care measures, i.e. annual well visits, vaccines, cancer screens, follow-up/specialist appointments, etc.</li></ul> 

Requirements 
<ul><li>
Fluent in English</li><li>
Self-directed, able to work independently with little supervision while meeting performance metrics</li><li>
Passion for nursing and improving patient outcomes</li><li>
Good with technology and eager to learn and use new software</li><li>
Excellent organizational and time management skills</li><li>
Strong communication and telephonic skills</li><li>
Strong critical thinking and problem-solving skills</li></ul>
Education and Experience:<ul><li>
Current, unrestricted Illinois RN license is required.
</li><li>Proficiency with EHRs (electronic health records) and web-based applications
</li><li>3 or more years' experience as a Registered Nurse</li></ul>
Preferred Education and Experience:<ul><li>
Case Management or Chronic Disease Management experience highly preferred
</li><li>Certified Diabetes Educator desired, but not required</li><li>
Experience with Motivational Interviewing or other behavior change communication techniques is a plus.</li></ul>
Scheduling and Other Requirements<ul><li>
Must have a STRONG internet-connected computer. Equipment is NOT provided by the company.</li><li>
A minimum of 20 hours of day time availability per week is required.
</li><li>You will commit to your own schedule using our software.</li><li>
This is a 1099 contract position with no end date. Care Coaches are responsible for their own equipment, taxes and insurance.</li></ul> 

Benefits 
Compensation:
Compensation is paid at the rate of $15.00 per initial clinical encounter per patient per month. A clinical encounter occurs after two criteria are met: a patient has a successful clinical call and the patient has 20 minutes or more of time in their chart timer.
<ul><li>Ex: If in one hour you called and spoke with 2 patients and spent 20 minutes with each of them, your pay for that hour would be $30.00 ($15.00/pt reached x 2).
</li></ul>Pay Timing:
*Your first check will be paid monthly via direct deposit, 40 days after the last day of the month of service. This is due to the time it takes Medicare to process reimbursements. All other checks after the first one will be deposited about 30 days after the last day of the month of service.*
Fraud Alert:
CircleLink Health has identified fraudulent emails sent from @joincirclelinkhealth.team, which is NOT affiliated with our company. Official CircleLink emails come only from @circlelinkhealth.com. Please report any suspicious messages to info@circlelinkhealth.com.
About CircleLink Health:
CircleLink Health is a company of passionate clinicians, technologists and businesspeople tackling the $600B problem of preventable chronic and post-acute complications. We&rsquo;re building a world-class Care Management platform to enable providers while accelerating the shift to preventative care instead of status quo reactive care. Learn more about us here.</div>

Illinois Licensed Registered Nurse Care Coach - Remote

Humana

<div><h1 class="jobSectionHeader">Become a part of our caring community and help us put health first 
</h1>
The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Field Care Manager Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
How we value you!<ul><li>
Competitive Pay, including eligibility for annual performance-based bonus</li><li>
Employee Referral Program</li></ul>
The Field Care Manager Nurse employs a variety of strategies, approaches, and techniques to manage a member's physical, environmental, and psychosocial health needs.<ul><li>
Must reside in Michigan with the ability to drive to Wayne and/or Macomb Counties.</li><li>
This position is based out of a home office and requires traveling 75&ndash;90% of the time within an assigned area in Wayne and/or Macomb County to conduct in‑home visits with Medicare/Medicaid members.</li></ul>
Position Responsibilities:<ul><li>
The RN Field Care Manager will be responsible for managing a caseload and completing assessments with members in their home or community‑based setting, as well as telephonically.</li><li>
Provides clinical support and guidance, particularly for members with medical complexity. Helps develop and coordinate care plans, ensuring that members receive appropriate services to manage their health needs effectively. Addresses barriers to care and advocates for optimal member outcomes.</li><li>
Reviews, assesses, and completes medical complexity attestations and clinical oversight activities.</li><li>
Ensures members receive services in the least restrictive setting to achieve and/or maintain optimal well‑being by assessing their care needs.</li><li>
Develops and modifies the Individual Care Plan and involves applicable members of the care team (informal caregiver, coach, PCP, etc.) in the care‑planning process.</li><li>
Focuses on supporting members and/or caregivers using an interdisciplinary approach to access social, housing, educational, and other services&mdash;regardless of funding source&mdash;to meet identified needs.</li><li>
Serves as the primary point of contact for the Interdisciplinary Care Team (ICT) and is responsible for coordinating with the member, ICT participants, and external resources to ensure the member&rsquo;s needs are met.</li></ul><h1 class="jobSectionHeader"> 

Use your skills to make an impact 

</h1>Required Qualifications<ul><li>
Must reside in the state of Michigan (Wayne or Macomb Counties)</li><li>
Active Michigan license as a Registered Nurse (RN) or Advanced Practice Registered Nurse (APRN), including Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS), with no disciplinary action</li><li>
2+ years' experience in Health Care and/or Case Management</li><li>
Ability to travel to homes and community settings for face-to-face assessments</li><li>
Experience working with the adult population, disease management.</li><li>
Knowledge of community health and social service agencies and additional community resources</li><li>
Ability to use a variety of electronic information applications &amp; software programs including electronic medical records</li><li>
Excellent keyboard and web navigation skills</li><li>
Intermediate to Advanced computer skills and experience with Microsoft Word, Outlook, and Excel</li></ul>
Preferred Qualifications<ul><li>
BSN</li><li>
Experience with in home assessment and care coordination experience</li><li>
Experience with health promotion, coaching and wellness</li><li>
Experience with Medicaid Long Term Care</li><li>
Previous managed care experience</li><li>
Bilingual- Spanish, Arabic or Chaldean Neo-Aramaic</li><li>
Certification in Case Management</li><li>
Motivational Interviewing Certification and/or knowledge</li></ul>
Additional Information<ul><li>Schedule/Time Zone: Monday through Friday, 8:30 AM &ndash; 5:00 PM Eastern Time Zone</li><li>Work Location: Michigan (Wayne and Macomb Counties)</li><li>Work Style: Field</li><li>Travel Requirements: 75%- 90% travel within Wayne and/or Macomb Counties, MI)
</li></ul>Work-at-Home (WAH) Internet Statement: To ensure Home or Hybrid Home/Office employees&rsquo; ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:<ul><li>
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.</li><li>
Satellite, cellular and microwave connection can be used only if approved by leadership.</li><li>
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.</li><li>
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.</li><li>
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.</li></ul>
TB Statement: This role is considered patient facing and is part of Humana&rsquo;s Tuberculosis (TB) screening program. If selected for this role, you will be required to be screened for TB.
Driving Statement: This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain personal vehicle liability insurance. Individual must carry vehicle insurance in accordance with their residing state minimum required limits, or $25,000 bodily injury per person/$25,000 bodily injury per event /$10,000 for property damage or whichever is higher.
Eligible mileage includes:<ul><li>
Travel from your home to your first work location of the day.</li><li>
Travel between client or assignment locations during the workday.</li><li>
Travel from your final work location back to your home.</li></ul>
Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
Language Assessment Statement: Any Humana employee who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. 

$71,100 - $97,800 per year 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<h1 class="jobSectionHeader"> 
About us 
</h1>
Humana Inc. (NYSE: HUM) is committed to putting health first &ndash; for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health &ndash; delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. 
 
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</div>

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