RN Care Manager at Christian Care Ministry
Orlando, Florida, USA -
Full Time


Start Date

Immediate

Expiry Date

11 Sep, 25

Salary

99500.0

Posted On

12 Jun, 25

Experience

3 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Critical Thinking, Computer Skills, Base Pay, Microsoft Office, Outlook, Organizational Performance, Regulations, Utilization Management, Case Management, Excel, Transitional Care

Industry

Hospital/Health Care

Description

ESSENTIAL SKILLS & ABILITIES

  • Expert knowledge of all Medi-Share program guidelines and processes
  • Excellent ability to communicate effectively with internal and external customers of all types in written, oral, telephonic, and digital formats that build engagement, interest, and facilitate positive outcomes
  • Excellent researching, analytical, and critical-thinking skills
  • Advanced planning and organizational skills; works effectively without supervision
  • Advanced skill with Microsoft Office (Word, Excel, Outlook)
  • Excellent computer skills – ability to access, research and use multiple software programs simultaneously and keyboard skills of at least 35 words per minute
  • Ability to collaborate effectively and professionally with interdisciplinary team members, embers/patients, families, providers, facilities and other employees and departments
  • Ability to comply with HIPAA and PHI requirements and all call compliance rules and regulations
  • Strong ability to work independently and with a team
  • Ability to handle conflict situations effectively
  • Strong ability to adapt to changing processes
  • Excellent ability to provide all content within a biblical framework

EDUCATION AND/OR EXPERIENCE

  • Registered Nurse with a current unrestricted multi-state compact license or willingness to pursue required
  • Bachelor of Science in Nursing required
  • 3+ years nursing experience required
  • 2+ years of case management and/or utilization management required
  • Nurse coaching experience preferred
  • Transitional care and transplant clinical experience highly preferred
  • Have or willing to obtain a certification in either case management or managed care nursing within two years
Responsibilities

ESSENTIAL JOB DUTIES & RESPONSIBILITIES

  • Performs within licensed scope of nursing practice and under the direction of the Sr. Director, Clinical Services
  • Identifies, screens, and enrolls members meeting criteria into Care Management Services
  • Educates members and providers (as appropriate) regarding the Medi-Share provisions and processes
  • Confirms member’s condition and plan of care are eligible for sharing based on Medi-Share and FDA/CMS approved evidence-based clinical management guidelines; suggests resources for those conditions/plan of care not eligible for sharing
  • Identifies, educates, and facilitates member participation in appropriate member stewardship including, but not limited to patient assistance programs for medication, laboratory, and genetic testing
  • Provides disease/condition specific clinical education to include multimedia resources, if available
  • Identifies opportunities for and facilitates transitional care
  • Partners with organizational resources to facilitate effective and cost-efficient outcomes for members
  • Delivers accurate and comprehensible verbal and written communication to external customers while complying with organizational HIPAA requirements
  • Documents case work, all telephone conversations, correspondence, and tasks completely and accurately in appropriate IT systems
  • Maintains and independently manages assigned caseload and departmental workflows within agreed service levels
  • Presents accurate, complete, and concise case information to Sr. Director, Clinical Services within agreed upon service levels
  • Completes medically related special projects independently as assigned with minimal supervision
  • Attends all required departmental and organizational meetings
  • Prays with members and providers as appropriate
  • Contribute to the exercise and expression of Christian Care Ministry’s Christian beliefs
  • Perform all other duties as assigned
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