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The Registered Nurse (RN) Care Manager will facilitate communication among patients/families, multidisciplinary teams, and community resources to identify and resolve barriers to care. This role involves interpreting contracts to achieve optimal clinical and financial outcomes, and collaborating with various care teams to ensure quality, efficient, and cost-effective healthcare services. The position may be embedded within a provider office or conducted telephonically. The nurse will utilize evidence-based approaches to enhance patient and family engagement in their own care, develop SMART goals with patients, and assist in the development of self-management educational resources. Identifying potential barriers to learning and care delivery, reporting abnormal findings, and managing a caseload independently are key responsibilities. The role ensures timely completion of tasks and documentation related to MCO, regulatory, and contractual requirements, and partners with at-risk patients to deliver continuity of care. The nurse will anticipate patient needs, respond to changes in status, and prioritize care based on essential patient needs. Coordination of patient information and communication between various entities, including referring/accepting facilities and physicians, community caregivers, and internal teams, is crucial for smooth transitions of care. Referrals to internal departments and external community resources will also be coordinated as necessary. The position requires the ability to demonstrate knowledge and skills appropriate for the age of the patients served, including understanding growth and development across the lifespan and assessing patient status relative to age-specific needs.
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Job Type
Full-time
Career Level
Mid Level

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