As a Care Coordinator Nurse, you are responsible for providing care coordination for Medicaid, Medicare Advantage, and/or Dual Eligible Special Needs Plan (DSNP) members. You will create a positive experience for members by building trusted relationships with each member. This includes helping members access the right care at the right time with the health plan, providers, pharmacies, other vendors, and community-based organizations. You will assess and work with members to address both their medical and social needs (SDOH).
Job Requirements:
- Licensed Practical Nurse (LPN) or Registered Nurse (RN) (license must be valid, unrestricted, and multi-state compact)
- Must be fluent in Spanish and English
- 2+ years experience as a care coordinator, case manager, community health worker, pharmacy technician, or social worker
- Must be located in the Central Time Zone (CST)
- Dedicated home office for remote work
- 1+ years of remote work experience
- Experience working with Medicaid and/or Dual Eligible patients
- Strong interpersonal, communication (both verbal and written), and problem-solving skills
- Experience with discharge planning
- Experience working with customers over the phone and by text message.
- Experience with Apple computers (i.e., MacBook) preferred
- Experience documenting case notes in a care management or electronic health record platform
- Experience with motivational interviewing
Key Responsibilities
- Conduct outreach to motivate, facilitate, and educate members about the benefits of programs.
- Conduct assessments of the member’s status and develop a care plan with the member to address their goals. Assessments are conducted by telephone and/or text.
- Evaluate individual member care needs and communicate medical information to health care professionals.
- Manage a caseload of members to ensure expedient contact is made with each member.
- Facilitate coordination of care with providers and schedule appointments as needed. Motivate members to be active and engaged participants in their health and overall well-being.
- Identify and help address needs related to Social Determinants of Health.
- Coordinate and complete correspondence according to established workflows.
- Thoroughly and accurately document actions taken in a care management platform.
- Make a high volume of outreaches to members, families, providers, or other recipients as needed to successfully perform the role.
Ability To:
- Work effectively in a multi-cultural setting with a wide range of populations in a diverse community, while demonstrating knowledge and continued learning of the assigned community’s cultures and values.
- Be an advocate for, support, and motivate members to manage their health and healthcare.
- Maintain positive working relationships with members and their families, providers, and other external partners.
- Build trust, actively listen, intentionally communicate, collaborate, and problem-solve.
- Influence others toward positive outcomes.
- Show passion for helping people improve their lives.
- Move forward after setbacks or difficult interactions with members, using setbacks as learning opportunities for personal and professional growth.
Schedule:
- 8-hour shift during normal business hours, according to the assigned contract
- Five days per week, Monday - Friday
Work Location:Remote (must be in Central Time (CST))
Benefits:
- Competitive compensation packages
- 401(k) with employer matching
- Medical, dental, and vision insurance, including a 100% employer-paid option
- Paid time off, paid sick time off, and paid holidays
- Remote work
- Comprehensive training and development
- 100% employer-paid short-term disability, long-term disability, and basic life insurance
- Health Savings Plan with employer contributions
- Employee assistance program (EAP)
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