Care Manager, RN

Jobtailor; Macomb (MO); On-site; USD 65,000 - 90,000; Full time

Job summary

Jobtailor is seeking a registered nurse to join our team as a care manager in Missouri. The role focuses on coordinating complex care for members with physical health needs, developing tailored care plans, and educating families to achieve high-quality, cost-effective outcomes.

The successful candidate will assess barriers to care, collaborate with providers, and continuously monitor progress toward goals. This role may involve telephonic and in-person outreach to ensure timely access to

Qualifications

• Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing.
• 2–4 years of related experience.
• RN - Registered Nurse - State Licensure required.

Responsibilities

• Develop, assess, and facilitate complex care management activities for members to provide high quality, cost‑effective healthcare outcomes.
• Evaluate needs and barriers to accessing care, focusing on member priorities and plan for best outcome.
• Develop ongoing care plans and collaborate with providers to identify resources to address unmet needs.
• Identify problems/barriers to care and provide care management interventions.
• Coordinate between member/family and care team to ensure person-centered care.
• Provide ongoing follow up and monitor status and revise care plans as needed.
• Provide resource support to members for local services.
• Facilitate care management and ensure timely access to needed care or services.
• May perform telephonic, digital, home, or other outreach to assess needs.
• Collect and maintain all member information to ensure compliance with regulators.
• Provide education to members and families on disease processes and care options.
• Provide feedback to leadership on opportunities to improve care delivery.

Skills

Care coordination

Communication

Patient education

Education

BSN or RN degree

Job description

Responsibilities

• Develop, assess, and facilitate complex care management activities for primarily physical needs members to provide high quality, cost‑effective healthcare outcomes including personalized care plans and education for members and their families.
• Evaluate the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommend and/or facilitate plan for the best outcome.
• Develop ongoing care plans / service plans and collaborate with providers to identify providers, specialists, and/or community resources to address member's unmet needs.
• Identify problems/barriers to care and provide appropriate care management interventions.
• Coordinate as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person‑centered care or services.
• Provide ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs.
• Provide resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate.
• Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services.
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources.
• Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and third‑party payer regulators.
• Provide and/or facilitate education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits.
• Provide feedback to leadership on opportunities to improve and enable care and quality delivery for members in a cost‑effective manner.

Qualifications

• Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing.
• 2 – 4 years of related experience.
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required.