RN Case Manager: Care Coordination & Advocacy

Doctors HealthCare Plans, Inc.; Coral Gables (FL); On-site; USD 65,000 - 85,000; Full time

Job summary

Doctors HealthCare Plans, Inc. in Florida is seeking a Nurse Case Manager to coordinate care for assigned members, optimize resource use, and ensure adherence to medical regimens.

You will perform assessments, participate in case conferences, and advocate for patients throughout the care continuum. Responsibilities include coordinating with physicians and care teams, managing referrals and entitlements, and maintaining accurate patient data.

Qualifications

• RN or LPN licensure required.
• Managed Care experience preferred.
• Bi-lingual English and Spanish preferred.
• Ability to take action in solving problems, exhibiting sound judgement.
• Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts.
• Demonstrate strong organization and time management skills.

Responsibilities

• Assist SNP Case Manager Director with MBR’s HRA outreach calls.
• Be the system navigator and point of contact for patients enrolled in managed care programs, assist patients with benefit coverage and access to care questions/ concerns.
• Provide enhanced care coordination services assisting patients in problem solving with issues related to the health care system, financial or social barriers.
• Identify and link patients with cultural and community resources to facilitate referrals and respond to social services needs.
• Collaborate with other services providers for care coordination and case management activities.
• Work with patients over the phone to review and remind their plan of care and progress towards their care management goals.
• Conduct outreach activities to assigned members by phone, mail or any other form of communication method to promote program engagement and marketing strategy Assist in data collection and report statistical information.
• Performs other job duties as required by manager/ supervisor.

Skills

Bilingual English Spanish

Communication skills

Problem solving

Time management

Education

RN or LPN licensure

Job description

Doctors HealthCare Plans, Inc. in Florida is seeking a Nurse Case Manager to coordinate care for assigned members, optimize resource use, and ensure adherence to medical regimens.

You will perform assessments, participate in case conferences, and advocate for patients throughout the care continuum. Responsibilities include coordinating with physicians and care teams, managing referrals and entitlements, and maintaining accurate patient data.