Remote RN Care Manager

Summary

Join Belong Health as a Registered Nurse (RN) Care Manager for the ACO Reach program, where you will apply care management principles to engage beneficiaries and providers, coordinate care, and develop individual care plans.

Requirements

• Two or more years of experience in a health plan, health care organization (i.e. hospital or clinic), or Accountable Care Organization (ACO)
• Proficient in navigating multiple systems; strong demonstrated PC skills using Microsoft applications
• Experience in participating in cross departmental projects and policy and procedure changes, including coordination of activities and initiatives across departments
• Excellent customer service, trend identification, and analytical skills, with a demonstrated ability to problem solve effectively and efficiently; strong organizational and follow-through skills
• Commitment to high ethical standards in all work; protects the privacy of member and company data and exercises discretion in handling confidential member information
• Excellent oral and written communication skills, including presentation skills
• Strong active listening, issue assessment and problem-solving skills
• Self-directed and able to work autonomously and as part of a collaborative team
• Comfortable in a fast-paced environment with multiple cases; able to organize and prioritize work
• Excellent time management skills; organized and able to prioritize
• A Bachelor of Science in Nursing (BSN) or equivalent is required
• Active, unrestricted compact nursing license is required

Responsibilities

• Work directly with beneficiaries, their families and/or advocates, providers, and community service organizations on an ongoing basis to coordinate care that is safe, timely, effective, efficient, equitable, and reduces barriers to care
• Orient new members to the Belong Health ACO program and educate the beneficiary and/or caregivers to care management services
• Advocate, empower, inform, and educate beneficiaries on self-management techniques
• Conduct assessments to identify barriers and opportunities for intervention
• Develop and implement the individual care plan (ICP)
• Lead interdisciplinary care team meetings
• Collaborate with provider, social workers, discharge planners, and community-based service providers to coordinate care and achieve care plan goals
• Document all care management activities in the appropriate system in accordance with internal and established documentation procedures
• Review electronic health records to gather information about beneficiary medical, behavioral health, and social conditions
• Promote a culture of accountability and performance to meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex, specialized, and non-routine customer issues

Preferred Qualifications

• Previous care management experience
• Knowledge of community services and resources
• Bi-lingual Spanish speaking