RN Care Manager

Christian Care Ministry•Melbourne, FL

1d•$73,000 - $99,500•Onsite

About The Position

The RN Care Manager serves as the key point of contact and coordinator of care to members experiencing an acute, catastrophic, or costly health care event. The RN Care Manager assists members and their providers in best navigating and utilizing the Medi-Share provisions and provider network for improved clinical outcomes, clinically substantiated courses of treatment, timely and improved access to cost-effective care, and greater member satisfaction.

Requirements

Expert knowledge of all Medi-Share program guidelines and processes
Excellent ability to communicate effectively with internal and external customers of all types in written, oral, telephonic, and digital formats that build engagement, interest, and facilitate positive outcomes
Excellent researching, analytical, and critical-thinking skills
Advanced planning and organizational skills; works effectively without supervision
Advanced skill with Microsoft Office (Word, Excel, Outlook)
Excellent computer skills – ability to access, research and use multiple software programs simultaneously and keyboard skills of at least 35 words per minute
Ability to collaborate effectively and professionally with interdisciplinary team members, embers/patients, families, providers, facilities and other employees and departments
Ability to comply with HIPAA and PHI requirements and all call compliance rules and regulations
Strong ability to work independently and with a team
Ability to handle conflict situations effectively
Strong ability to adapt to changing processes
Excellent ability to provide all content within a biblical framework
Registered Nurse with a current unrestricted multi-state compact license or willingness to pursue required
Bachelor of Science in Nursing required
3+ years nursing experience required
2+ years of case management and/or utilization management required
Have or willing to obtain a certification in either case management or managed care nursing within two years

Nice To Haves

Nurse coaching experience preferred
Transitional care and transplant clinical experience highly preferred

Responsibilities

Performs within licensed scope of nursing practice and under the direction of the Sr. Director, Clinical Services
Identifies, screens, and enrolls members meeting criteria into Care Management Services
Educates members and providers (as appropriate) regarding the Medi-Share provisions and processes
Confirms member’s condition and plan of care are eligible for sharing based on Medi-Share and FDA/CMS approved evidence-based clinical management guidelines; suggests resources for those conditions/plan of care not eligible for sharing
Identifies, educates, and facilitates member participation in appropriate member stewardship including, but not limited to patient assistance programs for medication, laboratory, and genetic testing
Provides disease/condition specific clinical education to include multimedia resources, if available
Identifies opportunities for and facilitates transitional care
Partners with organizational resources to facilitate effective and cost-efficient outcomes for members
Delivers accurate and comprehensible verbal and written communication to external customers while complying with organizational HIPAA requirements
Documents case work, all telephone conversations, correspondence, and tasks completely and accurately in appropriate IT systems
Maintains and independently manages assigned caseload and departmental workflows within agreed service levels
Presents accurate, complete, and concise case information to Sr. Director, Clinical Services within agreed upon service levels
Completes medically related special projects independently as assigned with minimal supervision
Attends all required departmental and organizational meetings
Prays with members and providers as appropriate
Contribute to the exercise and expression of Christian Care Ministry’s Christian beliefs
Perform all other duties as assigned

Benefits

100% paid Medical for employees/99% for family
Generous employer Health Savings Account (HSA) contributions
Employer-paid Life Insurance (3x salary) and Long-term Disability Insurance
6 weeks of paid parental leave (for both mom and dad)
Dental - two plans to choose from
Vision
Short-term Disability
Accident, Critical Illness, Hospital Indemnity
401(k) – up to 4% match on ROTH or Traditional contributions
Generous paid-time off and 11 paid holidays
Wellness plan including Financial, Occupational, Mental/Spiritual, and Physical health incentives up to $50/mo
Employee Assistance Program including no cost, in-person mental health visits and employee discounts
Monetary Anniversary Awards Program
Monetary Birthday Awards