Senior Care Manager (RN)

This is a remote position based in Washington State. Hours are Monday through Friday, 8:00 am–5:00 pm Pacific Standard Time (PST). Washington State RN Licensure and/or Compact State Licensure required.

About the role

Assess, plan, and implement complex care management activities based on member activities to enable quality, cost-effective healthcare outcomes. Develop a personalized care plan/service plan for members, address issues, and educate members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.

Responsibilities

• Develop and continuously assess ongoing care plans/service plans and collaborate with providers to identify providers, specialists, and/or community resources needed to address member's unmet needs.
• Coordinate and manage 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.
• Monitor care plans/service plans and/or member status, change in condition, and progress 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.
• Review member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations.
• Review referrals information and intake assessments to develop appropriate care plans/service plans.
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources.
• Collaborate with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed.
• Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
• Provide and/or facilitate education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits.
• Partner 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 onboarding process to upskill readiness.
• Provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provide coaching and shadowing opportunities to bridge gap between classroom training and field practice.
• Engage and assist new hire/preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for service coordination success.
• Engage in a collaborative and ongoing process with people leaders and cross-functional teams to measure and monitor readiness.
• Perform other duties or responsibilities as assigned by people leader to meet business needs.

Requirements

• Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing.
• 4–6 years of related experience.
• RN – Registered Nurse – State Licensure and/or Compact State Licensure required.

Pay

$75,300.00 – $135,400.00 per year. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives.

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible approach to work with remote, hybrid, field, or office work schedules.