Care Manager (RN)
Core
Develops, assesses, and facilitates complex care management activities for members with primarily physical needs to provide high-quality, cost-effective healthcare outcomes including personalized care plans and education.
Role type
Senior IC care manager (nursing)
Builds
Personalized care plans and service plans for members and their families
Domain
Healthcare / Care Management
Required skills
Registered Nurse (RN) licensure, care plan development, care coordination, resource identification, health education, regulatory compliance, data documentation, telephonic outreach, needs assessment, provider collaboration
Preferred skills
Experience with social determinants of health, knowledge of community resources (housing, employment, justice systems), familiarity with third-party payer regulations
Technologies
Telephonic platforms, digital outreach tools, care management software
Responsibilities
Evaluate member needs and barriers to care; develop and update care plans; coordinate between members, families, and providers; monitor member status and progress; provide education on disease processes and benefits; document care activities for compliance; facilitate access to community resources.
Seniority
Mid-level, hands-on IC