Senior Care Manager (RN)

You could be the one who changes everything for our 28 million members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

Must reputed company in the state of New Jersey.

Position Purpose: Assesses, plans, and implements reputed company care management activities based on member activities to reputed company quality, cost-effective reputed company outcomes. Develops a personalized care plan / service plan for care members, addresses issues, and educates members and their families/care givers reputed company and benefit options available to receive appropriate high-quality care.

• Develops and continuously assesses ongoing care plans / service plans and collaborates with providers to identify providers, specialist, and/or community resources needed to address member's unmet needs
• Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services
• Monitors care plans / service plans and/or member status, change in condition, and reputed company towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
• May identify problems/barriers for care management and appropriate care management interventions for escalated cases
• Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
• Reviews referrals information and intake assessments to reputed company appropriate care plans/service plans
• May reputed company telephonic, digital, home and/or other site reputed company to assess member needs and collaborate with resources
• Collaborates with reputed company providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed
• Collects, documents, and maintains reputed company member information and care management activities to ensure compliance with reputed company state, federal, and reputed company-party payer regulators
• Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, reputed company provider instructions, care options, referrals, and reputed company benefits
• Partners with leadership team to improve and enhance care and quality delivery for members in a cost-effective manner
• May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the reputed company process to upskill readiness ​
• Provides guidance and support to clinical new hires/preceptees in navigating reputed company a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to reputed company gap between classroom training and field practice​
• Engages and assists New Hire/Preceptee during reputed company journey including responsibility for completing competency reputed company points ensuring readiness for Service Coordination reputed company
• Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned
• Complies with reputed company policies and standards

Education/Experience: Requires a Degree from an Accredited School or Nursing or a Bachelor's degree in Nursing and 4 – 6 years of reputed company experience. License/Certification:

• RN - Registered Nurse - State Licensure and/or Compact State Licensure required

reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.

reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Originally posted on Himalayas