Point32Health · 10 hours ago
SCO RN Care Manager - Quincy/Randolph Area
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Responsibilities
Administer assessments, collaborate with the member/caregiver and providers to develop a plan of care, implement member-specific CM interventions, and evaluate plan of care and revise as needed.
Facilitate program enrollment utilizing key motivational interviewing skills
Provide targeted health education, proactive strategies for condition management, and communication with key providers and vendors actively involved in the member’s care
Perform both telephonic and face to face outreach to assess barriers to wellness, medical, behavioral, and psychosocial needs of the member.
Collaborate with member/caregiver and the facility care team to coordinate a safe transition to the next level of care, which includes but is not limited to ensure understanding post-hospital discharge instructions, facilitate needed services and follow-up, and implement strategies to prevent re-admission
Performs case documentation in applicable CM system according to department and regulatory standards
Collaborates and liaises with the interdisciplinary care team, to improve member outcomes (i.e., Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness, and BH CM)
Attend and present (as appropriate), high risk members at interdisciplinary rounds forum
Maintain professional growth and development through self-directed learning activities
Other duties and projects as assigned.
Qualification
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Required
Registered Nurse with current unrestricted license in state of residence
May be required to obtain other state licensure in states where Point32Health operates
5+ years’ relevant clinical experience
Skill and proficiency in technical concepts and principles; computer software applications
Skilled in assessment, planning, and managing member care
Advanced communication and interpersonal skills
Independent and autonomous with key job functions
Ability to address multiple complex issues
Flexibility and adaptability to changing healthcare environment
Ability to organize and prioritize work and member needs
Demonstration of strong clinical and critical thinking skills
Must be able to work under normal office conditions and work from remote office as required
Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations
Ability to make face to face visits (member home, provider practices, facilities) as needed to meet the member needs and produce positive outcomes
Valid Driver’s license and vehicle in good working condition as some travel required
May be required to work additional hours beyond standard work schedule
Preferred
Bachelor’s Degree in Nursing
National certification in Case Management
Experience in home care or case management
Proficiency in second language
Experience in specialty areas such as oncology, neurology, chronic condition/disease management
Benefits
Medical, dental and vision coverage
Retirement plans
Paid time off
Employer-paid life and disability insurance with additional buy-up coverage options
Tuition program
Well-being benefits
Full suite of benefits to support career development, individual & family health, and financial health
Company
Point32Health
Point32Health is a leading health & wellbeing organization, delivering an ever-better health care experience to everyone.
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
SMILE Health
2023-08-08Non Equity Assistance
Leadership Team
Recent News
Worcester Business Journal
2024-11-25
2024-10-24
2024-10-24
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