Care Manager, Registered Nurse- Remote

Lensa; Lansing (MI); Remote; USD 85,000; Full time

Job summary

An established industry player is seeking a dedicated Care Manager to support their Value Based Care Management program. This role involves high-quality telephonic Case Management, collaborating with members, caregivers, and healthcare providers to develop effective care plans. The ideal candidate will possess strong motivational interviewing skills and a background in clinical care, ensuring positive health outcomes for members. Join a forward-thinking organization that values your expertise and offers a comprehensive benefits package, making a significant impact on the lives of individuals in need of support.

Qualifications

• Current multi-state RN licensure required, BSN preferred.
• 3-5 years of clinical experience, particularly in telephonic Case Management.
• Proficiency in documentation and data analysis.

Responsibilities

• Engage with members to develop care plans and coordinate care.
• Collaborate with healthcare providers to meet health goals.
• Maintain documentation standards and adhere to program guidelines.

Skills

Motivational interviewing

Case management

Effective communication

Data analysis

Customer service

Problem-solving

Education

Current multi-state RN licensure

BSN preferred

3-5 years of clinical experience

Tools

Electronic medical records

Microsoft Office Suite

Job description

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Job Description

Job Summary:

Start Date: Monday, June 16th, 2025

Salary: $85,000 annually, plus comprehensive benefits package

The Care Manager supports the implementation of the Value Based Care Management program by providing high-quality telephonic Case or Care Management with CareFirst members. The Care Manager partners with members, caregivers, providers, and the interdisciplinary care team to ensure members have an effective plan of care and positive member experience that leads to improved health outcomes. The Care Manager advocates and guides using motivational interviewing techniques and intervenes on behalf of members to ensure successful completion of goals, providing Complex Case Management and support throughout the care plan.

Essential Job Functions

• Engage telephonically with members, caregivers, and providers to develop care plans, identify interventions, and address members' needs across the care continuum.
• Collaborate with PCPs, specialists, and clinicians to meet health goals through care plan development and implementation.
• Assess ongoing care needs and progress, revising plans as needed to address changes, lack of progress, or transitions in care settings.
• Coordinate patient education based on standards of care and health issues using appropriate modalities.
• Identify community resources and evaluate Social determinants of Health, facilitating referrals as needed.
• Assist in coordinating tests, imaging, and specialist consultations.
• Perform medication reconciliation regularly to assess efficacy and interactions.
• Manage transitions of care and follow-up post-discharge.
• Maintain documentation standards for care plans, tracking progress and barriers.
• Adhere to Value Based Care Management Program guidelines.
• Meet productivity and quality metrics annually.
• Complete mandatory training and participate in team activities.
• Stay current on clinical knowledge through self-directed learning.

Skills/Attributes

• Strong motivational interviewing and case management skills.
• Self-directed, organized, multi-tasking, and problem-solving abilities.
• Effective communication and customer service skills.
• Ability to work in a fast-paced environment with changing priorities.
• Experience engaging members and providing excellent customer service.
• Proficiency in data analysis and documentation of medical records.
• Experience with care plan documentation and working within organizational matrices.

Qualifications

• Current multi-state RN licensure, with ability to obtain additional licenses. BSN preferred.
• Training in motivational interviewing preferred.
• 3-5 years of clinical experience, with telephonic Case Management preferred.
• Proficiency with electronic medical records and Microsoft Office Suite.
• Home office must meet HIPAA and internet requirements.
• Effective communication skills with members and healthcare professionals.
• Ability to interpret scientific and technical information and present effectively.

Note: The incumbent must disclose any debarment or exclusion that affects eligibility to work on Federal health care programs.

Sharecare and its subsidiaries are Equal Opportunity Employers and E-Verify users. Consideration for employment is provided without regard to race, color, sex, national origin, sexual orientation, gender identity, religion, age, disability, genetic information, veteran status, or other protected status.