RN Care Manager

UNC Health; Old Farm (NC); On-site; USD 49,000 - 71,000; Full time

Job summary

The Care Manager RN at UNC Health provides comprehensive, coordinated care across Market sites in NC. You will perform patient assessments, develop patient-centered care plans, and manage care transitions with a focus on risk segmentation and payer communication.

Strong collaboration with healthcare teams and families is essential. Role requires nursing licensure in North Carolina, at least 2 years of RN experience, and proficiency with electronic health records.

Qualifications

• Graduation from a state-accredited school of professional nursing.
• North Carolina RN license.
• Minimum of 2 years of experience as a registered nurse.

Responsibilities

• Perform comprehensive care manager assessments using standardized tools and nursing knowledge.
• Develop individualized, evidence-based care plans with patients and families.
• Identify barriers to care and design interventions to address them.
• Coordinate tasks and interventions across the care team for seamless delivery.
• Coordinate care transitions across settings and support multidisciplinary meetings.
• Document and bill for services in compliance with regulatory requirements.

Skills

Risk segmentation

Patient assessments

Care plans

Care transitions

Payer communication

Education

BSN required or enrolled in accredited program within 4 years

Graduation from state accredited school of professional nursing

Job description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Join our team and help patients stay healthy through Annual Wellness Visits, chronic care management, and proactive preventive care. This is an opportunity to build relationships with patients, support their long-term health goals, and help them navigate their care beyond the traditional office visit.
If you’re a nurse who is passionate about prevention, patient engagement, and improving health outcomes, we would love for you to apply!

This position will be assigned to support:

Lenoir County Market

• UNC Family Medicine Complete Care 107 Airport Rd, Kinston
• UNC Family Medicine Complete Care 109 Airport Rd, Kinston
• UNC Complete Care La Grange

Wayne County Market

• UNC Internal Medicine Medical Office Place at Goldsboro
• UNC Family Medicine at Pikeville

Summary:
The Care Manager RN plays a crucial role in providing comprehensive and coordinated care to patients within UNC Health. This position involves utilizing a variety of skills, including risk segmentation, patient assessments, patient-centered care plans, tasks or interventions, care transitions, delegated work, and payer communication. The Care Manager works collaboratively with healthcare providers, patients, and their families to ensure that patients receive the highest quality of care and support throughout their healthcare journey.

Responsibilities:
1. Patient Assessments:
a. Conduct comprehensive care manager assessments utilizing standardized assessment tools and nursing knowledge to evaluate patients' functional abilities, cognitive status, and psychosocial support systems.
b. Identify any barriers to care and develop appropriate interventions to address them.
2. Patient-Centered Care Plans:
a. Collaborate with providers, patients, their families, and the healthcare team on individualized care plans that align with patients' goals, preferences, and values.
b. Ensure that care plans are evidence-based, culturally sensitive, and promote patient engagement and self-management.
3. Risk Segmentation:
a. Utilize standardized tools and clinical judgment to identify and assess the risk level of patients based on various factors such as medical conditions, social determinants of health, and behavioral health needs.
b. Develop strategies to effectively manage and mitigate risks for patients, ensuring their overall well-being and optimal health outcomes.
4. Tasks or Interventions:
a. Coordinate and facilitate necessary tasks or interventions to support patients' care plans.
b. Collaborate with healthcare providers, community resources, and support services to ensure seamless coordination of care.
c. Advocate for patients' needs and rights, ensuring that they receive appropriate and timely interventions.
d. Participates in quality improvement initiatives to ensure patient, departmental, and organizational goals/outcomes are met or exceeded.
5. Care Transitions:
a. Coordinate and facilitate care across various healthcare settings, ensuring seamless transitions and continuity of care.
b. Communicate and collaborate with healthcare providers, specialists, and community resources to ensure comprehensive and coordinated care delivery.
c. Facilitate multidisciplinary care team meetings to discuss patients' care plans and progress.
6. Coordinated Work:
a. Coordinate care management tasks with other members of the healthcare team while maintaining accountability for the overall coordination and management of patients' care as applicable per patient population.
7. Payer Communication:
a. Collaborate with payers, insurance companies, and utilization management teams to optimize reimbursement and facilitate timely approvals for necessary care and services.
8. Accurately document and bill for services rendered, as applicable, in compliance with insurance and regulatory requirements.
a. Collaborate with billing and coding professionals, as applicable, to ensure compliance with coding and documentation requirements.
9. Longitudinal Care as part of the Medical Home (varies per patient population and care setting):
a. Act as a key point of contact and advocate for patients within the care team.
b. Provide ongoing support and care coordination throughout the patient's healthcare journey, ensuring continuity and comprehensiveness of care.

Other Information

Other information:

Education Requirements:

• Graduation from a state accredited school of professional nursing
• Magnet hospitals: BSN required or must be enrolled in an accredited program within 4 years of employment and obtain a bachelor’s degree with a major in nursing or a master’s degree with a major in nursing within 7 years of employment date.

Licensure/Certification Requirements:

• Registered Nurse with a valid license to practice in North Carolina.

Professional Experience Requirements:

• Minimum of 2 years of experience as a registered nurse.

Knowledge/Skills/and Abilities Requirements:

• Strong knowledge of risk segmentation, patient assessments, patient-centered care planning, care transitions, and payer communication.
• Excellent communication, collaboration, and problem-solving skills.
• Ability to work independently and as part of a multidisciplinary team.
• Proficiency in electronic health records (EHR) and other relevant software applications.

Job Details

Legal Employer: NCHEALTH

Entity: UNC Health Medical Group

Organization Unit: Pop Health Care Management

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range:$35.87 - $51.57 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Kinston

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.