Peak Care Manager

Welcome! We’re excited you’re considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you’ll find other important information about this position. Reporting to Manager of Care Management, the Care Manager will be an integral member of the health plan’s medical management team. This position is responsible for identifying and connecting high risk members to appropriate resources and programs to achieve optimal quality and financial outcomes. Responsibilities include managing and triaging self-referrals, identifying high risk members through HRA, reporting and admissions data, auditing patient charts of delegated case management programs to meet accreditation standards, and connect members with in-network providers and resources. This position is committed to the constant pursuit of excellence in improving the health status of the community. MINIMUM QUALIFICATIONS : EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC). EXPERIENCE: 1. Three (3) years of healthcare clinical experience. PREFERRED QUALIFICATIONS : EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN); Currently enrolled in a BSN program and BSN completion within three (3) years of hire. EXPERIENCE: 1. Management of Medicare and/or Medicaid populations. 2. Two (2) years Care Management experience. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Participate in activities related to care manag