Remote Community-Based Care Manager (RN)

Upper Peninsula Health Plan (UPHP); Saint Ignace (MI); Remote; USD 33,777 - 48,107; Full time

Benefits offered by this job

Competitive pay

Comprehensive health insurance

401(k)

Student Loan Repayment Programs

Tuition Reimbursement

12 paid holidays

No mandatory overtime, nights, or week

Remote work

Job summary

UPHP is seeking a Remote Community Based Clinical Coordinator - Care Manager to perform care management duties, assess and coordinate medical services for enrolled members, and promote high-quality cost-effective care across the continuum.

The role requires Michigan RN license and 2+ years clinical experience, with travel for home visits as needed. Benefits include health insurance, 401(k), tuition reimbursement, and paid holidays.

Qualifications

• Licensed registered nurse licensed in Michigan per MDHHS.
• Two years of clinical or health-related experience as a licensed RN or SW.
• Preferred: care management experience or five years clinical experience.
• Valid driver’s license with proof of insurance; working vehicle.

Responsibilities

• Follow UPHP policies, safety standards, and confidentiality.
• Perform care management tasks across the continuum of care.
• Conduct in-person visits with members in homes and facilities.
• Assess health status and develop plans of care with defined objectives.
• Monitor referrals to community-based services and coordinate care.
• Address health-related social needs and advocate for members.
• Collaborate with care teams to ensure discharge and care plans.
• Identify and report quality concerns and NCQA standards.
• Contribute to process improvements and policy development.
• Maintain knowledge of MDHHS, CMS, DIFS, NCQA, and HEDIS standards.
• Provide backup support during high workload and attend meetings.
• Maintain confidentiality and perform related duties.

Skills

Keyboarding proficiency

MS Word

MS Excel

Oral and written communication

Organizational skills

Data interpretation

PowerPoint

MS Access

Education

Bachelor of Science in Nursing (BSN)

Licensed Social Worker (LSW) or social work licensure (MSW licensure)

Job description

UPHP is seeking a Remote Community Based Clinical Coordinator - Care Manager to perform care management duties, assess and coordinate medical services for enrolled members, and promote high-quality cost-effective care across the continuum.

The role requires Michigan RN license and 2+ years clinical experience, with travel for home visits as needed. Benefits include health insurance, 401(k), tuition reimbursement, and paid holidays.