Pediatric Nurse Care Manager
Remote
We're looking for a Newborn/Pediatric Nurse Care Manager for our Care and Case Management team, who is passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading interventions.You will report to the Manager, Care and Case Management and guide members through complex Medical and Behavioral Health situations, partnering with a diverse clinical team that includes a variety of healthcare professionals, care coordinators, and records specialists, to deliver integrated remote care in a creative way. As a Nurse Care Manager in this role, you will enjoy spending time on the phone, listening to members' needs, answering questions, and serving as an advocate. You will create cohesive care plans, and have the clinical skills to guide members clinically and navigate available benefits and resources. You will support members through complex care management, disease management, and acute case management, ensuring they receive longitudinal care that results in excellent health outcomes.Schedule: Monday-Friday 9am-6pm PST#LI-Remote
Responsibilities:
- Deliver coordinated, patient-centered virtual Care Management by telephone and video that improves members' health outcomes.
- Create impactful care plans together with members and our diverse care team, and help members achieve the desired goals.
- Help members navigate complex medical conditions, treatment pathways, benefits, and the healthcare system in general.
- Partner with the members' local providers to ensure coordinated care.
- Provide compassionate, longitudinal follow-up care, building supportive relationships.
- Assist throughout acute healthcare episodes, such as hospitalizations and rehabilitation stays, providing coordinated Case Management to support the member and their family.
- Coordinate necessary resources that holistically address members' problems, whether clinical or social
Required Qualifications:
- Bachelor of Science in Nursing (BSN).
- Must reside in a compact NLC state
- Active Compact RN license in good standing with the nursing board of their state.
- Active California Nursing License
- Willingness to become licensed in multiple states
- Must have current CCM Certification
- 2+ years experience working in Pediatric setting, preference for Behavioral Health experience
- 5+ years Nursing Experience
- Be able and willing to work until 6PM PST (M-F 9-6PM PST)
- Be comfortable discussing several medical conditions
- Experience working remotely
- Spanish Speaking desirable
- Be empathetic - We work with patients and their families who are going through challenging times. You practice empathy and reassure patients that we are available to help them.
- Can work efficiently- We are a fast-growing company and we are busy. Our team will meet volume goals without sacrificing quality.
- Strictly follow security and HIPAA regulations
- Be pleasant, responsive, and willing to work with and learn from our team.
- A lot of time is spent on the phone with patients and families, and a lot of time communicating with colleagues. Therefore, the ability to gather a clinical history, answer questions at a patient level, and summarize findings is critical.
- Strong competence and ability to use multiple computer/medical record systems.
- Collaborate well across diverse teams with clinical and non-clinical members to deliver a seamless, top-quality care experience to patients.
- Understand cultural and socioeconomic issues affecting members and to coordinate all available resources to serve members.
- Excellent grammar, and efficient at writing medical information in easy-to-understand, patient-centric language.
Physical/Cognitive Requirements
- Prompt and regular attendance at assigned work location.
- Capability to remain seated in a stationary position for prolonged periods.
- Eye-hand coordination and manual dexterity to operate keyboard, computer and other office-related equipment.
- No heavy lifting is expected, though occasional exertion of about 20 lbs of force (e.g., lifting a computer \/ laptop) may be required.
- Capability to work with leadership, employees, and members in an appropriate manner.
Job Profile
RestrictionsActive California nursing license required Must reside in a compact NLC state Willingness to become licensed in multiple states
Benefits/PerksBenefits Compassionate Leave Equity Flexible schedule Healthcare Remote work Supportive team environment Work-From-Home reimbursement
Tasks- Assist during acute healthcare episodes
- Coordinate resources
- Coordinate with local providers
- Create care plans
- Deliver virtual care management
- Navigate healthcare system
- Provide follow-up care
Acute care management Acute case management Behavioral health Care Coordination Care management Case Management Clinical Collaboration Computer Cultural Competence Disease Management Empathy Healthcare Leadership Management Manual Dexterity Medical record systems Nursing Organizational Patient advocacy Pediatric care Spanish Spanish Speaking Team Collaboration Telehealth Training Virtual care
Experience5 years
Education Certifications Timezones
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