Care Manager, Registered Nurse- Remote

Lensa; Saint Paul (MN); Remote; USD 85,000; Full time

Job summary

An established industry player is looking for a dedicated Care Manager to join their dynamic team. In this role, you will support the implementation of a Value Based Care Management program, ensuring high-quality telephonic case management for members. You will engage with members, caregivers, and providers to develop tailored care plans, advocate for member needs, and facilitate resources to enhance health outcomes. This position offers a unique opportunity to make a meaningful impact on the lives of individuals while working in a supportive and collaborative environment. If you are passionate about healthcare and possess strong case management skills, we encourage you to apply!

Qualifications

• 3-5 years of clinical experience with telephonic Case Management preferred.
• Ability to interpret scientific and technical information and present to diverse audiences.

Responsibilities

• Engage telephonically with members to develop comprehensive care plans.
• Coordinate patient education and facilitate referrals based on member needs.

Skills

Motivational interviewing

Case management

Communication skills

Data analysis

Problem-solving

Customer service

Multi-tasking

Documentation standards

Education

Current multi-state compact RN licensure

BSN preferred

Tools

EMRs

MS Office

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 member goals, providing Complex Case Management and support throughout the care plan.

Essential Job Functions

• Engage telephonically with members, caregivers, and providers to develop a comprehensive plan of care, identify key interventions, and address members' needs at various stages of the care continuum.
• Collaborate with PCPs, specialists, other clinicians, and members to meet healthcare goals through development and implementation of Care Plans.
• Assess ongoing care needs and progress, revising plans as needed to address changes, lack of progress, or transitions in care settings. Coordinate plans with goals of stabilization, decreased admissions, medication management, behavior change, and self-management.
• Coordinate patient education supporting standards of care and health issues using appropriate modalities.
• Identify benefit and community resources, evaluate Social Determinants of Health, and facilitate referrals based on member needs.
• Assist in coordinating tests, imaging, and specialist consultations.
• Perform medication reconciliation at the start, after health status changes, and periodically, assessing efficacy and interactions.
• Facilitate and monitor care transitions, ensuring follow-up post-discharge.
• Maintain documentation standards, recording member progress and barriers.
• Follow Value Based Care Management Program guidelines.
• Meet productivity and quality metrics annually.
• Complete mandatory training and annual competency testing.
• Participate actively in team huddles and clinical learning.
• Stay current with clinical knowledge through self-directed learning.

Specific Skills/Attributes

• Strong motivational interviewing and case management skills.
• Self-directed, organized, multi-tasking, and problem-solving abilities.
• Ability to meet deadlines.
• Excellent oral, written, and presentation skills.
• Effective communication and customer service skills.
• Ability to partner with all levels of staff.
• Resilience and adaptability in a fast-paced environment.
• Engagement skills for members; outstanding customer service.
• Ability to extract and synthesize information from medical records.
• Proficiency in data analysis and reporting.
• Experience with quality improvement processes.
• Experience with care plan documentation.
• Experience working within a matrix organizational structure.

Qualifications

• Current multi-state compact RN licensure; BSN preferred.
• Training in motivational interviewing preferred.
• 3-5 years of clinical experience with telephonic Case Management preferred.
• Computer competencies including EMRs, MS Office, and ability to learn customized applications.
• Home office must meet HIPAA and connectivity requirements.
• Effective communication skills with members and healthcare team.
• Ability to interpret scientific and technical information and present to diverse audiences.

Note: The incumbent must disclose any debarment, exclusion, or ineligibility to perform 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 under law.