Join to apply for the SelectHealth Care Manager-1 role at Intermountain Health
Base pay range
$40.00/hr - $60.00/hr
Job Description
Select Health is a community health plan serving more than 1 million members. Select Health’s line of businesses include Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans, and fully funded and self-funded Commercial Employer plans.
The Care Manager works with Select Health members, their family, caregivers, and a multi-disciplinary care team in a collaborative process of assessment, planning, facilitation, navigation, coordination, evaluation and advocacy in order for member to access benefits, resources, and services to meet comprehensive medical, behavioral, and social needs of members while promoting self-management, quality, and cost-effective outcomes.
Essential Functions
The nurse care manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs.
The position educates patients and caregivers to help them manage their health care needs.
The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management.
Developing, documenting and implementing care plans to provide the appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs.
Identifying members unable to adhere to a medical plan or who require complex additional assistance and enrolling and following them in longitudinal care management services.
Following the applicable established model of care or care management program policies and procedures to assess, establish and maintain a plan of care that incorporates the member's individualized needs and goals within the benefit plan throughout the care management process.
Ensuring the plan is evidence based and consistent with goals and objectives of referral, payer contract, or established care processes.
Maintaining records by reviewing case notes, logging events and progress according to applicable regulatory requirements such as NCQA, CMS and State EQRO standards.
Coordinating and facilitating communication among the member/family/representative, members of the healthcare team, and other relevant parties (e.g., other payers, Sales Team, Employer Groups, etc.) through interdisciplinary team meetings or other coordinated communication.
Contacting patient at prescribed intervals and as necessary to determine if the goals are being achieved or if they continue to be appropriate and/or realistic.
Determining variances and referring patients to a more comprehensive level of care if indicated.
Skills
Care Management
Care Planning
Clinical Nursing
Independent and autonomous
Motivational Interviewing
Prioritization & time management
Problem Solving
Psychosocial evaluations
SMART Goals
Verbal and Written Communication
Minimum Qualifications
Current license to practice as a Registered Nurse in the state residing. At minimum, need to obtain valid licenses in Utah, Nevada, Idaho and Colorado within 60 days of start of employment.
Demonstrated experience and expertise working in clinical nursing.
Minimum 1-year experience in care management/navigation or closely related field including Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health, quality, or patient educator job role.
Strong written, verbal communication and conflict resolution skills.
Intermediate computer software and hardware skills, ability to customize computer settings and use multiple monitors and capable of independent troubleshooting of internet and applications.
RNs hired or promoted into this role need to have or obtain their BSN within three years of hire or promotion.
Preferred Qualifications
Bachelor's degree in nursing (BSN) from an accredited institution.
Case Management Certification.
Three years of experience and expertise working in clinical nursing in an ambulatory care setting, community health or home care.
Experience working with third party payers.
Ability to work independently and be flexible in a rapidly changing environment.
Demonstrated excellent written and verbal communication skills.
Experience working successfully in a remote environment or using Advanced Microsoft Suite, including Teams & Outlook.
Physical Requirements
Ongoing need to see and read information, documents, monitors, identify equipment and supplies, and assess customer needs.
Frequent interactions with colleagues and providers require verbal communication and hearing and understanding spoken information, needs, and issues quickly and accurately.
Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy, including frequent computer use for typing and accessing needed information.
May be expected to sit or stand in a stationary position for a long time.
Location
SelectHealth - Murray, Murray, Utah
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$40.39 - $60.96
Benefits
We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
EEO Statement
Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
Other
All positions subject to close without notice.