Rn Care Coordinator Jobs

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Care Coordinator (Care Manager) - Registered Nurse (RN), Social Worker, or Clinical Counselor - R10249-6

CareSourceCanton, OHonsite

From $62,700/yr

Job Summary The Community Based Care Coordinator, Duals Integrated Care is responsible for managing and coordinating care for dual-eligible beneficiaries, those who qualify for both Medicare and Medicaid. This position focuses on integrating health services and community resources to improve health outcomes and enhance the quality of life for individuals with complex health needs, including those who are eligible for waiver services. Essential Functions * Engage with the member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member. * Function as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to ensure seamless communication and care transitions. * Conduct comprehensive assessments to identify the physical, mental, and socials needs of dual-eligible individuals. * Develop and implement individualized care plans based on unique needs of each member, considering their medical, social, and behavioral health requirements. * Lead and collaborate with interdisciplinary care team (ICT) to create holistic care plans that address medical and non-medical needs. * Assist members in accessing community resources, including housing, transportation, food assistance, and social services. * Educate members about their benefits and available services under both Medicare and Medicaid. * Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. * Promote health lifestyle choices and self-management strategies. * Regularly monitor member’s health status and care plan adherence, adjusting, as necessary. * Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. * Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information. * Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services. * Participate in care team meetings to discuss member progress and address barriers to care. * Maintain accurate and up-to-date records of members interactions, care plans, and outcomes. * Collect and analyze data to evaluate the effectiveness of care coordination efforts and identify areas of improvement. * Advocate for the needs and preferences of dual-eligible beneficiaries within the healthcare system. * Empower members to take an active role in their healthcare decisions. * Evaluate member satisfaction through open communication and monitoring of concerns or issues. * Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program. * Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law. * On-call responsibilities as assigned. * Adherence to NCQA and CMSA standards. * Perform any other job duties as requested. Education And Experience * Nursing degree from an accredited nursing program or bachelor’s degree in a health care field or equivalent years of relevant work experience is required. * Previous experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required. * Prior experience in care coordination, case management, or working with dual-eligible populations is preferred * Medicaid and/or Medicare managed care experience is preferred Competencies, Knowledge And Skills * Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. * Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries. * Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers * Ability to manage multiple cases and priorities while maintaining attention to detail. * Adhere to code of ethics that aligns with professional practice. * Awareness of and sensitivity to the diverse backgrounds and needs of the populations served * Decision making and problem-solving skills. Licensure And Certification * Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned. * Case Management Certification is highly preferred * Must have valid driver’s license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. * To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. * CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions * This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. * Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need. * May be required to travel greater than 50% of time to perform work duties. * Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer. * Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. Compensation Range $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type Salary Competencies * Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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D

RN Clinical Care Coordinator - Denver Health Medical Plan (* Hybrid Work Schedule *)

Denver HealthDenver, CO, UShybrid

$84,968 - $131,705/yr

We are recruiting for a motivated RN Clinical Care Coordinator - Denver Health Medical Plan (\ Hybrid Work Schedule ) to join our team! We are here for life’s journey. Where is your life journey taking you? Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all: Humanity in action, Triumph in hardship, Transformation in health. Department Managed Care Administration Hybrid Work Schedule* Job Summary Under general supervision, the Transition Care Coordinator (RNCC) is responsible for facilitating and coordinating the care delivered to an assigned group of members through multidisciplinary and member/family collaboration to ensure quality and cost effective outcomes are delivered within appropriate care coordination parameters. Coordination involves assessment, planning, support, and evaluation of member care and related outcomes. Activities to be performed are screening and assessment of medical, behavioral health and social determinants needs and gaps in care, collaboration with the Member to develop a care plan with SMART (SMART goals are: Specific, Measurable, Attainable, Relevant and Timely) goals, periodic outreach within defined timeframes to support member in achieving their goals and supporting the Members self-efficacy to navigate systems. RNCC communicates closely with the Member's care team inclusive of: the member, the member's designated health representatives, primary care provider, behavioral health providers and other care coordinators involved with the Member's care. Essential Functions:* Use DHMP Care Management protocols and critical thinking to assess, identify opportunities to improve Member healthcare outcomes, collaboratively set SMART goals with the Member, develop a care plan with interventions and support and enable the Member to achieve their goals and independently navigate needed services to improve overall health outcomes. (10%) * Visit members with complex needs in community based settings, including community centers, hospitals or providers' offices. (10%) * Provide a complete continuum of quality care through close communication with members via in-person, phone or electronic interaction. (10%) * Support members with education relevant to their disease process, medication reviews and connections to community resources such as food, housing or financial support programs. (10%) * The RNCC will work with members with complex needs, prioritize care management and work with a multidisciplinary team to support the needs of the Members on their caseloads. (10%) * Document in readable, understandable language according to professional, regulatory, and agency standards. (10%) * Document and disseminate results of care to member, caregivers, and others involved in the care or situation, as appropriate, in accordance with contractual requirements, state and federal laws, regulatory requirements, and Denver Health policy. (10%) * RNCC will be responsible for a defined caseload of Members identified as needing Complex Care Management (CCM) or Population Health Management/Disease Management (PHM) services. (10%) * Members meet the threshold for CCM by meeting defined threshold conditions, including multiple chronic physical health and/or behavioral health conditions, polypharmacy, high costs of care, avoidable use of high cost services and/or associated social health disparities. (10%) * Members meet the threshold for PHM by having at least one of several defined conditions, including a chronic physical or behavioral health condition, like diabetes or depression; a person with special health care needs; high-risk pregnancy or other identified condition. (10%) Education:* Associate's Degree Nursing required Work Experience:* 1-3 years of clinical experience in a hospital, acute care, home health/hospice, direct care or case management required AND * 1-3 years of experience in care coordination or case management required Licenses:* RN-Registered Nurse - DORA - Department of Regulatory Agencies required Knowledge, Skills and Abilities:* Must have reliable transportation to travel to community-based locations within the Denver-metro area. * Bilingual ability English/Spanish. * Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action. * Ability to communicate verbally and in writing complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others. * Knowledge of health plan case management, care coordination, or member navigation. * Medicaid and Medicare Managed Care knowledge. * Skills working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs. * Knowledge and understanding of case management/coordination of care principles, programs, and processes in either a hospital or outpatient healthcare environment. * Ability to collaboratively support team members and/or staff to achieve pre-determined goals. Effectively collaborate with and respond to varied personalities in differing emotional conditions, and maintain professional composure at all times. Strong customer service orientation and aptitude required. Shift Days (United States of America) Work Type Regular Salary $84,968.00 - $131,705.60 / yr Benefits* Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans * Free RTD EcoPass (public transportation) * On-site employee fitness center and wellness classes * Childcare discount programs \& exclusive perks on large brands, travel, and more * Tuition reimbursement \& assistance * Education \& development opportunities including career pathways and coaching * Professional clinical advancement program \& shared governance * Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program * National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer Our Values* Respect * Belonging * Accountability * Transparency All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made. Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver’s 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison \& Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation. As Colorado’s primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year. Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. Denver Health is an equal opportunity employer (EOE). We value the unique ideas, talents and contributions reflective of the needs of our community. Applicants will be considered until the position is filled.

6 months agovia universal intelligenceApply ›

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RN Care Coordinator

Kintegra HealthConcord, NC, USonsite

From $24/yr

Job Summary and Specifications Job Title: Clinic Nurse FLSA Status: ExemptSalary Range: See Salary ScaleJob Summary: Responsible for providing direct and indirect nursing care to assigned Senior Total Life Care (TLC) participants in a clinic, home or community-based model of care in the STLC service area. Works under the direct and indirect supervision of the Center Manager but is independent in the application of advanced nursing knowledge and skills. Manages complex clinical situations for which (s)he is responsible. Works within an Interdisciplinary Team (IDT) to help care for the holistic needs of Senior TLC participants. Takes an active part in the care planning process and provides nursing interventions as appropriate. Provides on-call phone triage on weekdays, weekends, holidays and emergency situations on a rotating basis and documents those calls/visits in the Electronic Medical Record (EMR). Completes in-home aid re-assessments and supervisory visits as requested by the Home Care Agency (HCA) Supervisor. Specifications ================== Education: Graduate of an accredited school of nursing and a current RN license. Experience: Has practiced nursing in the last 3 years; 2 years of RN experience preferred including experience working with the frail elderly population. Number and Type of Employees Supervised (optional): Licensed and non-licensed personnel Licensure, Registry or Certification Required: RN currently licensed in North Carolina; or compact state, able to present credentials which demonstrate ability to meet performance criteria for RN. Special Training: Must possess knowledge and skills necessary to treat participants; other training as required by department. Only act within the scope of his or her authority to practice. Meets a standardized set of competencies for the specific position description established by Senior TLC and approved by CMS before working independently. Immunizations: Be medically cleared for communicable diseases and have all immunizations up to date before engaging in direct participant contact Ages of Patients Rendered Care: Neonate/Infant Early Childhood Adolescent Adult Geriatric All Age GroupsKey Responsibilities: (\denotes an age-related skill or task) Collects participant data and completes required forms with appropriate responses according to unit standards; identifies participant’s overt problems/needs and sets priorities; identifies problems requiring further referral and/or follow-up; interprets and records latest diagnostic results; and performs advanced nursing assessments using critical thinking skills. * Performs wound care, skin care and other treatments as ordered by the Primary Care Provider (PCP) and documents in the EMR and logs as appropriate. Documents participant care delivered as planned and any variation, with appropriate rationale; makes and records observations related to impending or associated problems; implements nursing measures related to impending or associated problems. * Schedules participants to be seen in the clinic per the IDT. Works with Clinic Technician and PCP along with the IDT to assess participants with holistic needs in the clinic setting. May provide End of Life Care and visits as requested. * Using nursing process, delegates nursing care to appropriate personnel; integrates cost effective measures into nursing practice; recognizes unit problems and takes responsibility for documenting; demonstrates active participation in QI processes; complies with policies addressing safe working conditions; monitors unsafe working conditions; recognizes inappropriate and/or ineffective participant care management, resolves issue/problem and completes written reports. * Takes on-call as scheduled on a rotating basis and documents those calls promptly. Makes home visits to provide care in crisis situations, to perform assessments, and provide nursing care as requested by the IDT. During emergency procedures, makes participant welfare checks and documents those calls. May be required to deliver medications to participants to ensure continuity of care. * Completes in-home aid re-assessments and supervisory visits as requested by the HCA Supervisor. Provides feedback to the IDT and the HCA on results of those visits to support participants’ plans of care. * Attends staff meetings and takes part in participant care planning as required, including Quality Projects as appropriate. Completes clinic reviews and wound logs in a timely manner. * Provides directions to Clinic Technician and oversees their treatments/procedures. Assists Medication Aides with monthly orders and reconciling those orders. * Completes initial, at least every six-month reassessment, and significant change assessments. * Participates in participant care planning including the implementation of SMART goals/interventions for the participants’ care plans and enters all care plan information in a timely manner as per organizational protocols. Updates and evaluates participants’ care plans appropriately throughout the reassessment period. * Participates in the coordination of 24-hour care delivery while participants are at home, in the hospital, or in a nursing facility, including medication reconciliations. Communicates participant changes to team members in a timely and appropriate manner. * Supports the Senior TLC IDTs and promotes unity amongst team members while interacting with the team, other coworkers, and/or participants. * Supports team members and functions as a team player while providing that support and adheres to the “do no harm” statement. Accepts teammate’s professional and cultural differences as they relate to participant care and supports team’s decisions while promoting a united team for the participants’ continuity of care and for staff development. * Supports Senior TLC’s mission to encourage and support the quality of life of seniors wishing to continue living in the community; its vision to be the preferred provider of individualized care for seniors in the community; and its values of respect, integrity, accountability, compatible goals, and compassionate care. * Other duties as assigned.

6 months agovia universal intelligenceApply ›

C

Care Coordinator (Care Manager) - Registered Nurse (RN), Social Worker, or Clinical Counselor - R10249-2

CareSourcePort Clinton, OHonsite

From $31/yr

Job Summary The Community Based Care Coordinator, Duals Integrated Care is responsible for managing and coordinating care for dual-eligible beneficiaries, those who qualify for both Medicare and Medicaid. This position focuses on integrating health services and community resources to improve health outcomes and enhance the quality of life for individuals with complex health needs, including those who are eligible for waiver services. Essential Functions * Engage with the member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member. * Function as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to ensure seamless communication and care transitions. * Conduct comprehensive assessments to identify the physical, mental, and socials needs of dual-eligible individuals. * Develop and implement individualized care plans based on unique needs of each member, considering their medical, social, and behavioral health requirements. * Lead and collaborate with interdisciplinary care team (ICT) to create holistic care plans that address medical and non-medical needs. * Assist members in accessing community resources, including housing, transportation, food assistance, and social services. * Educate members about their benefits and available services under both Medicare and Medicaid. * Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. * Promote health lifestyle choices and self-management strategies. * Regularly monitor member’s health status and care plan adherence, adjusting, as necessary. * Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. * Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information. * Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services. * Participate in care team meetings to discuss member progress and address barriers to care. * Maintain accurate and up-to-date records of members interactions, care plans, and outcomes. * Collect and analyze data to evaluate the effectiveness of care coordination efforts and identify areas of improvement. * Advocate for the needs and preferences of dual-eligible beneficiaries within the healthcare system. * Empower members to take an active role in their healthcare decisions. * Evaluate member satisfaction through open communication and monitoring of concerns or issues. * Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program. * Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law. * On-call responsibilities as assigned. * Adherence to NCQA and CMSA standards. * Perform any other job duties as requested. Education And Experience * Nursing degree from an accredited nursing program or bachelor’s degree in a health care field or equivalent years of relevant work experience is required. * Previous experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required. * Prior experience in care coordination, case management, or working with dual-eligible populations is preferred * Medicaid and/or Medicare managed care experience is preferred Competencies, Knowledge And Skills * Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. * Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries. * Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers * Ability to manage multiple cases and priorities while maintaining attention to detail. * Adhere to code of ethics that aligns with professional practice. * Awareness of and sensitivity to the diverse backgrounds and needs of the populations served * Decision making and problem-solving skills. Licensure And Certification * Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned. * Case Management Certification is highly preferred * Must have valid driver’s license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. * To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. * CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions * This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. * Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need. * May be required to travel greater than 50% of time to perform work duties. * Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer. * Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. Compensation Range $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type Salary Competencies * Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

6 months agovia universal intelligenceApply ›

C

Care Coordinator (Care Manager) - Registered Nurse (RN), Social Worker, or Clinical Counselor - R10249-5

CareSourceSpringfield, OHonsite

From $62,700/yr

Job Summary The Community Based Care Coordinator, Duals Integrated Care is responsible for managing and coordinating care for dual-eligible beneficiaries, those who qualify for both Medicare and Medicaid. This position focuses on integrating health services and community resources to improve health outcomes and enhance the quality of life for individuals with complex health needs, including those who are eligible for waiver services. Essential Functions * Engage with the member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member. * Function as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to ensure seamless communication and care transitions. * Conduct comprehensive assessments to identify the physical, mental, and socials needs of dual-eligible individuals. * Develop and implement individualized care plans based on unique needs of each member, considering their medical, social, and behavioral health requirements. * Lead and collaborate with interdisciplinary care team (ICT) to create holistic care plans that address medical and non-medical needs. * Assist members in accessing community resources, including housing, transportation, food assistance, and social services. * Educate members about their benefits and available services under both Medicare and Medicaid. * Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. * Promote health lifestyle choices and self-management strategies. * Regularly monitor member’s health status and care plan adherence, adjusting, as necessary. * Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. * Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information. * Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services. * Participate in care team meetings to discuss member progress and address barriers to care. * Maintain accurate and up-to-date records of members interactions, care plans, and outcomes. * Collect and analyze data to evaluate the effectiveness of care coordination efforts and identify areas of improvement. * Advocate for the needs and preferences of dual-eligible beneficiaries within the healthcare system. * Empower members to take an active role in their healthcare decisions. * Evaluate member satisfaction through open communication and monitoring of concerns or issues. * Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program. * Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law. * On-call responsibilities as assigned. * Adherence to NCQA and CMSA standards. * Perform any other job duties as requested. Education And Experience * Nursing degree from an accredited nursing program or bachelor’s degree in a health care field or equivalent years of relevant work experience is required. * Previous experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required. * Prior experience in care coordination, case management, or working with dual-eligible populations is preferred * Medicaid and/or Medicare managed care experience is preferred Competencies, Knowledge And Skills * Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. * Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries. * Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers * Ability to manage multiple cases and priorities while maintaining attention to detail. * Adhere to code of ethics that aligns with professional practice. * Awareness of and sensitivity to the diverse backgrounds and needs of the populations served * Decision making and problem-solving skills. Licensure And Certification * Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned. * Case Management Certification is highly preferred * Must have valid driver’s license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. * To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. * CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions * This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. * Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need. * May be required to travel greater than 50% of time to perform work duties. * Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer. * Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. Compensation Range $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type Salary Competencies * Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

5 months agovia universal intelligenceApply ›

C

Care Coordinator (Care Manager) - Registered Nurse (RN), Social Worker, or Clinical Counselor - R10249-8

CareSourceChardon, OHonsite

From $62,700/yr

Job Summary The Community Based Care Coordinator, Duals Integrated Care is responsible for managing and coordinating care for dual-eligible beneficiaries, those who qualify for both Medicare and Medicaid. This position focuses on integrating health services and community resources to improve health outcomes and enhance the quality of life for individuals with complex health needs, including those who are eligible for waiver services. Essential Functions * Engage with the member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member. * Function as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to ensure seamless communication and care transitions. * Conduct comprehensive assessments to identify the physical, mental, and socials needs of dual-eligible individuals. * Develop and implement individualized care plans based on unique needs of each member, considering their medical, social, and behavioral health requirements. * Lead and collaborate with interdisciplinary care team (ICT) to create holistic care plans that address medical and non-medical needs. * Assist members in accessing community resources, including housing, transportation, food assistance, and social services. * Educate members about their benefits and available services under both Medicare and Medicaid. * Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. * Promote health lifestyle choices and self-management strategies. * Regularly monitor member’s health status and care plan adherence, adjusting, as necessary. * Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. * Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information. * Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services. * Participate in care team meetings to discuss member progress and address barriers to care. * Maintain accurate and up-to-date records of members interactions, care plans, and outcomes. * Collect and analyze data to evaluate the effectiveness of care coordination efforts and identify areas of improvement. * Advocate for the needs and preferences of dual-eligible beneficiaries within the healthcare system. * Empower members to take an active role in their healthcare decisions. * Evaluate member satisfaction through open communication and monitoring of concerns or issues. * Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program. * Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law. * On-call responsibilities as assigned. * Adherence to NCQA and CMSA standards. * Perform any other job duties as requested. Education And Experience * Nursing degree from an accredited nursing program or bachelor’s degree in a health care field or equivalent years of relevant work experience is required. * Previous experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required. * Prior experience in care coordination, case management, or working with dual-eligible populations is preferred * Medicaid and/or Medicare managed care experience is preferred Competencies, Knowledge And Skills * Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. * Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries. * Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers * Ability to manage multiple cases and priorities while maintaining attention to detail. * Adhere to code of ethics that aligns with professional practice. * Awareness of and sensitivity to the diverse backgrounds and needs of the populations served * Decision making and problem-solving skills. Licensure And Certification * Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned. * Case Management Certification is highly preferred * Must have valid driver’s license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. * To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. * CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions * This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. * Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need. * May be required to travel greater than 50% of time to perform work duties. * Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer. * Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. Compensation Range $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type Salary Competencies * Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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C

Care Coordinator (Care Manager) - Registered Nurse (RN), Social Worker, or Clinical Counselor - R10249-4

CareSourceDelaware, OHonsite

From $62,700/yr

Job Summary The Community Based Care Coordinator, Duals Integrated Care is responsible for managing and coordinating care for dual-eligible beneficiaries, those who qualify for both Medicare and Medicaid. This position focuses on integrating health services and community resources to improve health outcomes and enhance the quality of life for individuals with complex health needs, including those who are eligible for waiver services. Essential Functions * Engage with the member in a variety of community-based settings to establish an effective, care coordination relationship, while considering the cultural and linguistic needs of each member. * Function as a liaison between healthcare providers, community resources, and dual-eligible beneficiaries to ensure seamless communication and care transitions. * Conduct comprehensive assessments to identify the physical, mental, and socials needs of dual-eligible individuals. * Develop and implement individualized care plans based on unique needs of each member, considering their medical, social, and behavioral health requirements. * Lead and collaborate with interdisciplinary care team (ICT) to create holistic care plans that address medical and non-medical needs. * Assist members in accessing community resources, including housing, transportation, food assistance, and social services. * Educate members about their benefits and available services under both Medicare and Medicaid. * Provide education to members and their families about managing chronic conditions, medication adherence, and preventive care. * Promote health lifestyle choices and self-management strategies. * Regularly monitor member’s health status and care plan adherence, adjusting, as necessary. * Follow up with members after hospitalizations or significant health events to ensure continuity of care and prevent readmissions. * Work closely with primary care physicians, specialists, and other healthcare providers to coordinate care and share relevant information. * Coordinate with community-based organizations, other stakeholders/entities, state agencies, and other service providers to ensure coordination and avoid duplication of services. * Participate in care team meetings to discuss member progress and address barriers to care. * Maintain accurate and up-to-date records of members interactions, care plans, and outcomes. * Collect and analyze data to evaluate the effectiveness of care coordination efforts and identify areas of improvement. * Advocate for the needs and preferences of dual-eligible beneficiaries within the healthcare system. * Empower members to take an active role in their healthcare decisions. * Evaluate member satisfaction through open communication and monitoring of concerns or issues. * Regular travel to conduct member, provider and community-based visits as needed and per the regulatory requirements of the program. * Report abuse, neglect, or exploitation of older adults as a mandated reporter as required by State law. * On-call responsibilities as assigned. * Adherence to NCQA and CMSA standards. * Perform any other job duties as requested. Education And Experience * Nursing degree from an accredited nursing program or bachelor’s degree in a health care field or equivalent years of relevant work experience is required. * Previous experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required. * Prior experience in care coordination, case management, or working with dual-eligible populations is preferred * Medicaid and/or Medicare managed care experience is preferred Competencies, Knowledge And Skills * Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. * Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries. * Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers * Ability to manage multiple cases and priorities while maintaining attention to detail. * Adhere to code of ethics that aligns with professional practice. * Awareness of and sensitivity to the diverse backgrounds and needs of the populations served * Decision making and problem-solving skills. Licensure And Certification * Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned. * Case Management Certification is highly preferred * Must have valid driver’s license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver’s license record check and verified insurance. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in the position will be terminated. * To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 – March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified. * CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process. Working Conditions * This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential. Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time. * Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need. * May be required to travel greater than 50% of time to perform work duties. * Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer. * Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members. Compensation Range $62,700.00 - $100,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type Salary Competencies * Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

5 months agovia universal intelligenceApply ›

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