RN Care Manager - Senior Care Options - Central Boston Elder Services and Ethos area - Bilingual preferred (Spanish)

Point32Health

96d

About The Position

The Care Manager – Nursing Field (RN CM) will ensure that all members receive timely care management (CM) across the continuum, including transitions of care, care coordination and navigation, complex case management, population health and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager possesses strong clinical knowledge, critical thinking skills, and ability to facilitate a care plan which ensures quality medical care for the member. The RN CM works closely with the member, the caregiver/authorized representative, and providers to meet the targeted member-specific goals. Based on national standards for CM practice, the RN CM focuses on empowering the member to support optimal wellness and improved self-management.

Requirements

• Registered Nurse with current unrestricted license in state of residence.
• May be required to obtain other state licensure in states where Point32Health operates.
• Understand and follow the provisions of state-specific Nurse Practice Act(s) where Point32Health operates.
• National certification in Case Management desirable.
• Bachelor’s degree or relevant equivalent experience.
• 5 years’ relevant clinical experience.

Nice To Haves

• Bachelor’s degree in nursing.
• Experience in home care or case management.
• Proficiency in a second language desirable.
• Experience in specialty areas a plus.

Responsibilities

• Perform telephonic member outreach and/or face-to-face encounter utilizing key motivational interviewing skills to facilitate program enrollment.
• Perform departmental assessments and evaluate member holistically to identify needs, health goals, and barriers to wellness.
• Through assessment and collaboration with member/caregiver and providers, develop a member-specific plan of care, implement member-specific care manager interventions, and revise plan of care as needed.
• Complete documentation in applicable platform according to departmental policy and regulatory standards.
• Provide targeted health education, proactive strategies for condition management, and communication with key providers and vendors actively involved in the member’s care.
• Collaborate with member/caregiver and the facility care team to coordinate a safe transition to the next level of care, which includes but is not limited to ensure understanding post-hospital discharge instructions, facilitate needed services and follow-up, and implement strategies to prevent re-admission.
• Collaborates and liaises with the interdisciplinary care team, to improve member outcomes (i.e., Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness, and Behavioral Health CM).
• Attending and presenting (as appropriate) high risk members at interdisciplinary rounds forum.
• Maintain professional growth and development through self-directed learning activities.

Benefits

• Medical, dental and vision coverage.
• Retirement plans.
• Paid time off.
• Employer-paid life and disability insurance with additional buy-up coverage options.
• Tuition program.
• Well-being benefits.
• Full suite of benefits to support career development, individual & family health, and financial health.

What This Job Offers

• Career Level: Mid Level
• Education Level: Bachelor's degree