Pediatric Nurse Care Manager

Summary

Join our team as a Newborn/Pediatric Nurse Care Manager and provide holistic care to members through their healthcare journey. You will report to the Manager, Care and Case Management and guide members through complex medical and behavioral health situations, partnering with a diverse clinical team. As a Nurse Care Manager, you will enjoy spending time on the phone, listening to members' needs, answering questions, and serving as an advocate. You will create cohesive care plans and guide members clinically, navigating available benefits and resources. You will support members through complex care management, disease management, and acute case management, ensuring they receive longitudinal care resulting in excellent health outcomes. The schedule is Monday-Friday, 9 am-6 pm PST, and the position is remote.

Requirements

• Bachelor of Science in Nursing (BSN)
• Must reside in a compact NLC state
• Active Compact RN license in good standing with the nursing board of their state
• Active California Nursing License
• Willingness to become licensed in multiple states
• Must have current CCM Certification
• 2+ years experience working in Pediatric setting, preference for Behavioral Health experience
• 5+ years Nursing Experience
• Be able and willing to work until 6PM PST (M-F 9-6PM PST)
• Be comfortable discussing several medical conditions
• Experience working remotely
• Strictly follow security and HIPAA regulations
• Strong competence and ability to use multiple computer/medical record systems
• Collaborate well across diverse teams with clinical and non-clinical members to deliver a seamless, top-quality care experience to patients
• Understand cultural and socioeconomic issues affecting members and to coordinate all available resources to serve members
• Excellent grammar, and efficient at writing medical information in easy-to-understand, patient-centric language
• Prompt and regular attendance at assigned work location
• Capability to remain seated in a stationary position for prolonged periods
• Eye-hand coordination and manual dexterity to operate keyboard, computer and other office-related equipment
• No heavy lifting is expected, though occasional exertion of about 20 lbs of force (e.g., lifting a computer / laptop) may be required
• Capability to work with leadership, employees, and members in an appropriate manner

Responsibilities

• Deliver coordinated, patient-centered virtual Care Management by telephone and video that improves members' health outcomes
• Create impactful care plans together with members and our diverse care team, and help members achieve the desired goals
• Help members navigate complex medical conditions, treatment pathways, benefits, and the healthcare system in general
• Partner with the members' local providers to ensure coordinated care
• Provide compassionate, longitudinal follow-up care, building supportive relationships
• Assist throughout acute healthcare episodes, such as hospitalizations and rehabilitation stays, providing coordinated Case Management to support the member and their family
• Coordinate necessary resources that holistically address members' problems, whether clinical or social

Preferred Qualifications

• Spanish Speaking desirable
• Be empathetic - We work with patients and their families who are going through challenging times. You practice empathy and reassure patients that we are available to help them
• Can work efficiently- We are a fast-growing company and we are busy. Our team will meet volume goals without sacrificing quality
• Be pleasant, responsive, and willing to work with and learn from our team
• A lot of time is spent on the phone with patients and families, and a lot of time communicating with colleagues. Therefore, the ability to gather a clinical history, answer questions at a patient level, and summarize findings is critical

Benefits

• Remote-first culture
• 401(k) savings plan through Fidelity
• Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
• Paid Time Off ("PTO") and Discretionary Time Off ("DTO")
• 12 weeks of 100% Paid Parental leave
• Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies
• Work-From-Home reimbursement to support team collaboration home office work