RN Care Manager - St. Louis or Kansas City

ArchWell Health • St. Louis, MO

10d • Remote

About The Position

ArchWell Health is re-imagining the practice of primary care by centering the patient-physician relationship within a value-based model focused on outstanding patient experience, improved access, and better outcomes. Our medical clinics provide comprehensive primary care for senior adults with traditional Medicare and Medicare Advantage plans, aiming to enhance quality, patient experience, and reduce the total cost of care.

The Nurse Care Manager is responsible for coordinating and evaluating the management of patients with acute and chronic conditions across the care continuum to achieve high-quality care and positive patient outcomes. This role involves close collaboration with the care team to follow patients from our centers into acute and post-acute facilities, and back to their home environments. The Nurse Care Manager plays a crucial role in developing and executing care plans alongside the care team to meet goals, performance standards, regulatory compliance, and ensure quality patient care.

Requirements

• Associate degree in Nursing required.
• A valid, active, unrestricted Registered Nurse (RN) license in State of employment required.
• Willingness to obtain an RN license in other states with an ArchWell Health center (compact and non-compact locations).
• A minimum of 2 years’ clinical work experience required.
• Proficient computer skills including Microsoft Office.

Nice To Haves

• Bachelor’s Degree in Nursing (BSN) or RN with bachelor’s degree in a related clinical field preferred.
• A minimum of 1 year of utilization review, home health, discharge planning experience highly desired.
• A minimum of 1 year of case management experience in acute case management or ambulatory case management experience highly desired.
• Certified Case Manager certification is preferred. Certification through the Commission for Case Manager Certification (CCMC) or the American Association of Managed Care Nurses (CMCN) or willingness to obtain certification within a specified time.
• ICD-10, CPT codes, HCPCS knowledge preferred.
• Managed care experience including knowledge of HEDIS and CMS guidelines preferred.
• Mission driven and motivated to join an organization that will transform the way we deliver accessible, clinically excellent care to seniors.
• Fluency in Spanish or other languages spoken by people in the communities we serve (where necessary).

Responsibilities

• Establish a trusting relationship with patients, their families, and/or caregivers.
• Collaborate with clinical staff and other care team members to achieve patient goals.
• Reduce network costs by driving referrals to preferred groups and identifying excessive referral requests.
• Identify high-risk/complex patients.
• Assess physical, functional, social, psychosocial, environmental, learning, and financial needs and develop a comprehensive, individualized care plan based upon identified needs.
• Perform case management following the nursing process and standards of practice established by the Case Management Society of America (CMSA).
• Provide patient education, care coordination, and other interventions needed to help patients achieve their health goals.
• Utilize Motivational Interviewing to build patient engagement.
• Evaluate progress toward patient’s goal achievement.
• Communicate telephonically with hospital case managers, physical therapists (PT), social workers, patients, and families/caregivers to facilitate a safe discharge plan.
• Manage and plan for transitions of care.
• Conduct transitions of care assessment/screening, medication reconciliation, and care coordination following discharge to home.

Benefits

• ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree