RN Care Manager — Coordinated Care for High-Risk Members

Maryland Care Management, Inc; Poland; Hybrid; PLN 90,000 - 130,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

100% employer Term Life Insurance

Short and Long-Term Disability

401k Employer Match up to 4%

20 days PTO

Tuition assistance/professional dev

Job summary

Maryland Care Management, Inc. is seeking a Care Manager to plan, develop, implement, and oversee care plans for high-risk members with identified needs.

This role focuses on improving coordination, continuity, and appropriate utilization of health care services and resources. You will collaborate with physicians and an interdisciplinary team, conduct assessments, and build relationships with community providers to ensure quality care while managing costs.

Qualifications

• Graduate of an Accredited School of Nursing.
• Current, unrestricted RN license in Maryland.
• 2+ years of clinical nursing experience in an acute care or community setting.
• 2+ years of Care Management experience.
• BSN preferred and CCM preferred.
• Experience assisting members with accessing community agencies and resources.

Responsibilities

• Develops, maintains, and monitors processes to identify high risk and special needs members.
• Acts as an interdisciplinary team member in member management with physicians.
• Conducts telephone or face-to-face interviews to identify risk factors for care management.
• Fosters networks with providers to promote continuity and quality of care.
• Develops and implements care plans to deliver quality care and service.
• Maintains care management records and ensures data integrity.
• Educates medical providers regarding members' special needs.
• Coordinates with community support and social services.
• Reduces care costs while maintaining quality.
• Collaborates with teams to remove care management barriers.
• Develops policies and procedures related to care management.
• Communicates with supervisor regarding departmental issues.

Skills

Microsoft Teams

Zoom

SharePoint

Communication skills

Microsoft Office 365

Education

Graduate of an Accredited School of Nursing

Current, unrestricted RN license in Maryland

BSN preferred

CCM preferred

Tools

Microsoft Teams

Zoom

SharePoint

Job description

Maryland Care Management, Inc. is seeking a Care Manager to plan, develop, implement, and oversee care plans for high-risk members with identified needs.

This role focuses on improving coordination, continuity, and appropriate utilization of health care services and resources. You will collaborate with physicians and an interdisciplinary team, conduct assessments, and build relationships with community providers to ensure quality care while managing costs.