About the role
We're looking for Nurse Care Managers for our Care and Case Management team, who hold a UT Compact RN license and also a CA RN license; have experience working with a health plan, health navigator or third-party administrator (TPA). Are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading interventions. As a telephonic Nurse Care Manager you will report to the Manager, Care and Case Management and will guide members through complex medical and behavioral Health situations, partnering with a diverse clinical team that includes a variety of healthcare professionals, care coordinators, and records specialists, to deliver integrated remote care in a creative way. The Nurse Care Manager should enjoy spending time on the phone, listening to members' needs, answering questions, and serving as an advocate. You will excel at creating cohesive care plans, and have the clinical skills to guide members clinically and navigate available
benefits and resources. Nurse Care Managers will support members through complex care management, disease management, and acute case management, ensuring they receive longitudinal care that results in excellent health outcomes. #LI-Remote \n
Responsibilities: Deliver coordinated, patient-centered virtual Care Management by telephone or video that improves members' health outcomes. Create impactful care plans together with members and our diverse care team, and help members achieve the desired goals. Help members navigate complex medical conditions, treatment pathways,
benefits, and the healthcare system in general. Partner with the members' local providers to ensure coordinated care. Provide compassionate, longitudinal follow-up care, building supportive relationships. Assist throughout acute healthcare episodes, such as hospitalizations and rehabilitation stays, providing coordinated Case Management to support the member and their family. Coordinate necessary resources that holistically address members' problems, whether clinical or social