Point32Health
RN Care Manager - Senior Care Options - Dorchester, South Boston, East Boston, D
Point32Health, Oklahoma City, Oklahoma, United States
RN Care Manager - Senior Care Options - Dorchester, South Boston, East Boston, Downtown, Chinatown, Cambridge, Somerville area - Bilingual preferred (Vietnamese)
Responsibilities and qualifications reflect a RN Care Manager role with Senior Care Options (SCO). The content describes coordinating care management across the continuum, transitions of care, disease and chronic condition management, and collaboration with an interdisciplinary team to improve member outcomes. The position emphasizes standard CM practices, member empowerment, and documentation per policy and regulatory standards. Overview
Point32Health is a not-for-profit health and well-being organization providing high-quality, affordable healthcare to nearly 2 million members. The organization emphasizes inclusion, empathy, and service to the communities it serves. Job Summary
The Care Manager – Nursing Field (RN CM) ensures timely care management across the continuum, including transitions of care, care coordination and navigation, complex case management, population health and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager uses clinical knowledge and critical thinking to facilitate a care plan that ensures quality medical care. The RN CM works with the member, caregiver/authorized representative, and providers to meet member-specific goals. Based on national CM standards, the RN CM focuses on empowering the member for optimal wellness and self-management. Key Responsibilities
Perform telephonic member outreach and/or face-to-face encounters using motivational interviewing to facilitate program enrollment. Conduct departmental assessments, identify needs/goals/barriers, develop and revise member-specific plans of care, and document in applicable platforms per policy and regulatory standards. Provide targeted health education, proactive condition management strategies, and communication with key providers and vendors involved in the member’s care. Coordinate safe transitions to the next level of care with the member/caregiver and facility care team, including post-discharge understanding, service facilitation, follow-up, and strategies to prevent readmission. Collaborate with the interdisciplinary care team to improve member outcomes (Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness and Behavioral Health CM). Attend and present high-risk members at interdisciplinary rounds as appropriate. Maintain professional growth through self-directed learning activities. Qualifications
Certification and Licensure
Registered Nurse with current unrestricted license in state of residence May be required to obtain other state licensure in states where Point32Health operates Understand and follow state-specific Nurse Practice Act(s) where Point32Health operates National certification in Case Management desirable Education
Required: Bachelor’s degree or relevant equivalent experience Preferred: Bachelor’s degree in nursing Experience
Required: 5 years’ relevant clinical experience Preferred: Experience in home care or case management Proficiency in a second language desirable Experience in specialty areas is a plus Skill Requirements
Microsoft applications and general computer software proficiency Team collaboration across organizational levels Assessment, planning, and management of member care Advanced communication and interpersonal skills Independent and autonomous with key job functions Ability to address multiple complex issues and adapt to changing healthcare environments Strong organizational and prioritization abilities Strong clinical and critical thinking skills Respect for confidentiality and compliance with policy Working Conditions and Additional Requirements
Work from normal office conditions and remote office as required May involve telephone/headset use and extended seated work Face-to-face visits to member homes, provider practices, or facilities as needed Valid driver’s license and vehicle required; travel may be needed May require additional hours beyond standard schedule Other duties as assigned COVID Policy
Follow CDC guidance on vaccines, boosters, isolation, and masking. Policies may be adjusted in response to trends in the communities served. Disclaimer
The statements describe the general nature and level of work and are not exhaustive. Management may adjust duties as needed. Compensation & Total Rewards
Point32Health offers a comprehensive total rewards package, including a competitive compensation structure with potential variable pay, and benefits such as: Medical, dental, and vision coverage Retirement plans Paid time off Employer-paid life and disability insurance with additional options Tuition program Well-being benefits Benefits supporting career development, health, and financial well-being For more details, visit the Point32Health careers benefits page. Equal Opportunity
All applicants are welcome and will be considered for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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Responsibilities and qualifications reflect a RN Care Manager role with Senior Care Options (SCO). The content describes coordinating care management across the continuum, transitions of care, disease and chronic condition management, and collaboration with an interdisciplinary team to improve member outcomes. The position emphasizes standard CM practices, member empowerment, and documentation per policy and regulatory standards. Overview
Point32Health is a not-for-profit health and well-being organization providing high-quality, affordable healthcare to nearly 2 million members. The organization emphasizes inclusion, empathy, and service to the communities it serves. Job Summary
The Care Manager – Nursing Field (RN CM) ensures timely care management across the continuum, including transitions of care, care coordination and navigation, complex case management, population health and wellness interventions, and disease/chronic condition management per department guidelines. The nurse care manager uses clinical knowledge and critical thinking to facilitate a care plan that ensures quality medical care. The RN CM works with the member, caregiver/authorized representative, and providers to meet member-specific goals. Based on national CM standards, the RN CM focuses on empowering the member for optimal wellness and self-management. Key Responsibilities
Perform telephonic member outreach and/or face-to-face encounters using motivational interviewing to facilitate program enrollment. Conduct departmental assessments, identify needs/goals/barriers, develop and revise member-specific plans of care, and document in applicable platforms per policy and regulatory standards. Provide targeted health education, proactive condition management strategies, and communication with key providers and vendors involved in the member’s care. Coordinate safe transitions to the next level of care with the member/caregiver and facility care team, including post-discharge understanding, service facilitation, follow-up, and strategies to prevent readmission. Collaborate with the interdisciplinary care team to improve member outcomes (Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness and Behavioral Health CM). Attend and present high-risk members at interdisciplinary rounds as appropriate. Maintain professional growth through self-directed learning activities. Qualifications
Certification and Licensure
Registered Nurse with current unrestricted license in state of residence May be required to obtain other state licensure in states where Point32Health operates Understand and follow state-specific Nurse Practice Act(s) where Point32Health operates National certification in Case Management desirable Education
Required: Bachelor’s degree or relevant equivalent experience Preferred: Bachelor’s degree in nursing Experience
Required: 5 years’ relevant clinical experience Preferred: Experience in home care or case management Proficiency in a second language desirable Experience in specialty areas is a plus Skill Requirements
Microsoft applications and general computer software proficiency Team collaboration across organizational levels Assessment, planning, and management of member care Advanced communication and interpersonal skills Independent and autonomous with key job functions Ability to address multiple complex issues and adapt to changing healthcare environments Strong organizational and prioritization abilities Strong clinical and critical thinking skills Respect for confidentiality and compliance with policy Working Conditions and Additional Requirements
Work from normal office conditions and remote office as required May involve telephone/headset use and extended seated work Face-to-face visits to member homes, provider practices, or facilities as needed Valid driver’s license and vehicle required; travel may be needed May require additional hours beyond standard schedule Other duties as assigned COVID Policy
Follow CDC guidance on vaccines, boosters, isolation, and masking. Policies may be adjusted in response to trends in the communities served. Disclaimer
The statements describe the general nature and level of work and are not exhaustive. Management may adjust duties as needed. Compensation & Total Rewards
Point32Health offers a comprehensive total rewards package, including a competitive compensation structure with potential variable pay, and benefits such as: Medical, dental, and vision coverage Retirement plans Paid time off Employer-paid life and disability insurance with additional options Tuition program Well-being benefits Benefits supporting career development, health, and financial well-being For more details, visit the Point32Health careers benefits page. Equal Opportunity
All applicants are welcome and will be considered for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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