RN Care Manager - Summacare

Summary :

Care Managers collaborate across a broad continuum of care to assess, plan, implement, coordinate, monitor and evaluate services to support and to meet individual member’s health care needs; coordinates with physicians and other providers to provide optimal care for the member; determines the appropriate level of support from self-management education to end-of-life services; refers to community resources and clinical programs to improve quality of life for the member and to meet organizational goals related to quality outcomes, member experience, and cost-ef

ficiency.

Formal Education Required :
a. Graduate of an accredited school of professional nursing or a school accepted for candidacy status from an accrediting body
b. Current license to practice registered nursing in the State of Ohio

Experience & Training Required :
a. Three (3) years’ experience to include previous industry, care coordination and/or homecare or community agency experience.
b. Prior Care Management experience with a Health Insurance Company preferred.
c. Certification Care Management (CCM) preferred

Other Skills, Competencies and Qualifications:
a. Typing of 30 Words per Minute with 96% accuracy rate.
b. High: ability to communicate instructional and operational information verbally and in written form that may include correspondence, reports, instructional materials, system designs; ability to provide instruction and guidance required to supervise day-to-day departmental operations; ability to interface with internal staff, mid-upper management professionals, and general public.
c. High: collecting, analyzing data from diverse sources; making recommendations and/or conclusions based on analyses; developing financial, data processing technical reports, procedures, systems that usually affect one department. Proofreading completed work to find and correct errors. Requires excellent attention to detail.
d. Demonstrate knowledge and skills necessary to provide care appropriate to the age of the members serviced.
e. Work cooperatively with team members to accomplish HSM mission and goals.
f. Organize and manage time to accurately complete tasks within designated time frames in fast paced environment.
g. Maintain current knowledge of and comply with regulatory and company policies & procedures.
h. Maintain confidentiality of member health and business information.
i. Flexible: ability to adjust work hours to meet business demands.
j. Frequent overtime work throughout the year, with heavy overtime during peak periods. Occasional travel for most Care Managers which may require use of personal auto to visit a member or provider office, attend meetings, conferences, workshops, and/or seminars.
k. Ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity

Level of Physical Demands:
a. Sit and/or stand for prolonged periods of time
b. Bend, stoop, and stretch.
c. Lift up to 20 pounds.
d. Manual dexterity to operate computer, phone, and standard office machines.

Equal Opportunity Employer/Veterans/Disabled

$33.66/hr - $50.49/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.