Care Manager (RN)
Core
Develops, assesses, and facilitates complex care management activities for Medicaid and dual-eligible members with physical, intellectual, developmental, or cognitive needs to provide high-quality, cost-effective healthcare outcomes.
Role type
Senior Registered Nurse Care Manager
Builds
Personalized care plans and service plans for members and their families
Domain
Healthcare / Medicaid / Dual-eligible Medicare/Medicaid / Social Determinants of Health
Required skills
Care plan development, provider coordination, resource identification, care gap resolution, member education, regulatory compliance, telephonic outreach, data documentation
Preferred skills
Experience with intellectual/developmental/cognitive needs, field-based member outreach, collaboration with specialists
Technologies
Telephonic tools, digital outreach platforms, 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 resource support for services like housing and employment; educate members and families on disease processes and benefits; document all care management activities for compliance.
Seniority
Mid-level, hands-on IC