Nurse Care Manager (RN)

Telligen; West Des Moines (IA); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Telligen is a population health management company dedicated to improving care quality and outcomes for diverse populations. In the Nurse Care Manager (RN) role, you will assess patients, collaborate with clinicians, educate families, and adjust care plans to meet contractual and regulatory requirements, in a hybrid setup at West Des Moines, IA or Oklahoma City, OK.

This position requires an RN license, a four-year healthcare degree, and 1-year in human services or 3 years clinical practice,

Qualifications

• Four-year degree in health care or related field or equivalent training/experience.
• Minimum 1 year in human services and/or 3 years clinical practice.
• RN license or licensure as health care provider; state licensure may be required for different clients.
• Hybrid position available at West Des Moines, IA or Oklahoma City, OK.

Responsibilities

• Performs assessment and evaluation of potential care management patients per client contractual obligations and/or state requirements.
• Collaborates with health care providers and ancillary service providers to validate the appropriate treatment plan and identify educational opportunities.
• Assessment/education may include face-to-face interaction for specific contracts.
• Effectively guides members to appropriate member benefit information.
• Provides ongoing education.
• Communicates with all health care providers to ensure appropriateness of care.
• May recommend and make adjustments in care if needed.
• Evaluates treatment adherence and reevaluates the patient's commitment to make the necessary changes.
• Documents per contractual requirements related to individual member status, and/or medical necessity review, negotiation.

Skills

RN license

Care management

Education

Four-year degree in health care or related field

Job description

As a Nurse Care Manager (RN), you will be responsible for care management of patients with acute and chronic medical conditions and the assessment of care needs of vulnerable populations for various clients.

This is a Hybrid position at either our West Des Moines, IA office or our Oklahoma City, OK office.

This position is contingent on obtaining a new, pending contract.

What You'll Do:

• Performs assessment and evaluation of potential care management patients per client contractual obligations and/or state requirements
• Collaborates with health care providers and ancillary service providers to validate the appropriate treatment plan and identify educational opportunities
• Assessment/education may include face-to-face interaction for specific contracts
• Effectively guides members to appropriate member benefit information
• Provides ongoing education
• Communicates with all health care providers to ensure appropriateness of care
• May recommend and make adjustments in care if needed
• Evaluates treatment adherence and reevaluates the patient's commitment to make the necessary changes
• Documents per contractual requirements related to individual member status, and/or medical necessity review, negotiation
• Escalates issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff members
• Performs miscellaneous duties as assigned

Required Skills and Experience:

• Four-year degree in health care or related field and/or equivalent training and/or experience
• Minimum 1 year experience in human services and/or 3 years clinical practice experience
• Licensure as a health care provider or current RN license
  • Some contracts may require state specific licensure
  • State licensure required for different clients in numerous states
  • Certain positions may require advanced certifications or the ability to obtain certifications within 4 years
• This is a Hybrid position at either our West Des Moines, IA office or our Oklahoma City, OK office.
• This position is contingent on obtaining a new, pending contract.

Who We Are:

Telligen is one of the most respected population health management organizations in the country. We offer clinical, analytical, and technical expertise to support local, Tribal, and national partners, state and federal government programs, and employers and health plans.

Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.

Our business is our people and we're seeking talented individuals who share our passion and are ready to take ownership, make an impact and help shape the future of health.

Are you Ready?

Benefits:

A general description of the benefits and other compensation available for this position can be found in Telligen's Benefits Summary.

We're on a mission to transform lives and economies by improving health.

Ownership:

As a 100% employee-owned company, our employee-owners drive our business and share in our success.

Community:

We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.

Ingenuity:

We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.

Integrity:

We foster a respectful, inclusive, and collaborative environment built on trust and excellence.

Thank you for your interest in Telligen!

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Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.

Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.

Telligen is an equal opportunity employer. Qualified applicants will be considered without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, protected veteran status, disability or any other protected class.

Telligen is committed to ensuring that our employment process is open to all individuals, and provides reasonable accommodations to individuals who need assistance during any part of the employment process due to a disability, medical condition, or physical or mental impairment. Reasonable accommodations are considered on a case-by-base basis.

If you need assistance to navigate Telligen's careers website or to apply for a position, please send an email to [e-mail]