Care Manager
Select Health is a community health plan serving more than 1 million members. 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 members to access benefits, resources, and services to meet comprehensive medical, behavioral, and social needs 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.
- This position is responsible for developing, documenting, and implementing care plans, which will provide the appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs.
- Identifies members unable to adhere to a medical plan or members that require complex additional assistance and enrolls and follows these members in longitudinal care management services.
- Follows the applicable established model of care or care management program policies and procedures to assess, establish and maintain a plan of care which incorporates the member's individualized needs and goals within the benefit plan throughout the care management process.
- Ensures the plan is evidence based and consistent with goals and objectives of referral, payer contract, or established care processes.
- Maintains records by reviewing case notes, logging events and progress according to applicable regulatory requirements.
- Coordinates and facilitates communication among the member/family/representative, members of the healthcare team, and other relevant parties through interdisciplinary team meetings or other coordinated communication.
- Contacts 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.
- Determines variances and refers 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
Physical Requirements
- Ongoing need for employees to see and read information, documents, and monitors.
- Frequent interactions with colleagues and providers require employees to verbally communicate and hear and understand spoken information.
- Manual dexterity of hands and fingers to manipulate complex and delicate equipment.
- May be expected to sit or stand in a stationary position for a long time.
Qualifications
- Minimum Qualifications
- Current license to practice as a Registered Nurse in the state residing.
- Demonstrated experience and expertise working in clinical nursing.
- Minimum 1-year experience in care management/navigation or closely related field.
- Strong written, verbal communication and conflict resolution skills.
- Intermediate computer software and hardware skills.
- RNs hired or promoted into this role need to have or obtain their BSN within three years.
- 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.
Location: SelectHealth - Murray
Work City: Murray
Work State: Utah
Scheduled Weekly Hours: 40
The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$40.39 - $60.96
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.
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.