Care Manager (RN)

Position Title: Care Manager (RN)

Work Location: Fort Lauderdale and Hollywood in Broward County

Assignment Duration: 3 months (Contract to hire)

Work Arrangement: Remote Florida w/member visits 50% remote - 50% member facing

Work Schedule: 8-5 M-F, no OT

Position Summary:

Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

Background & Context:

• This is a position for medically fragile pediatric members that require a face to face visit once a month with a second contact required telephonically once a month. These members have PDN (Private Duty Nursing) in the home caring for the member's needs to assist the caregivers. Caseload size is max 40 members. The RN care manager for this role will be required to offer this face to face visit, and if the parent declines then a virtual face to face visit may be offered. These members also require an annual assessment that can be conducted over the phone during a telephonic outreach. If the parent is unable to reach then the RN CM will be required to call the private duty nursing agency to obtain an update on the member's health status for the month. A monthly assessment is entered into our charting system at the end of the month to reflect the member's health status, visits attended, and summary of nursing staffing in the home for the month. The RN care manager's role is to assist the parent/caregivers with any needs or questions related to the member's care in the community setting.
• 8-5 M-F, no OT. This is a remote position that will require an organized individual to schedule face to face meetings, schedule and obtain the required telephonic contact for updates, and to compile that information timely into ECC assessments at the end of the month. One hour lunch break and 2 breaks daily are afforded for employee. The employee will be sent a company cell phone, computer, headset, and an additional monitor for charting prior to their start date. There are multiple team chats utilized daily where CMs share resources and assist each other with questions. The new hire will have a preceptor and a supervisor to assist.
• Offer face to face visit first and then if declined a virtual visit (pediatric care with nursing in home)
• Helping others daily and autonomy to schedule daily task for completion. The ECC team has a positive and vibrant team culture.
• This person should be passionate about pediatric care - they are seeking for someone who is wanting a long term position as this role is intended to convert

• Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome
• Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
• Identifies problems/barriers to care and provide appropriate care management interventions
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services
• Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
• Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate
• Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
• May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
• Other duties or responsibilities as assigned by people leader to meet business needs
• Performs other duties as assigned.
• Complies with all policies and standards.

• Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 - 4 years of related experience.
• RN - Registered Nurse - State Licensure and/or Compact State Licensure required
• For YouthCare Illinois plan only: Bachelor's Degree and IL RN licensure required. Must reside in IL
• For our organization (FL) Only: Employees supporting Florida's Children's Medical Services (CMS) must have a minimum of two years of pediatric experience. May require up to 80% local travel required
• Must haves: Pediatric experience of 2 years minimum
• Nice to haves: Case Management experience
• Disqualifiers: not meeting minimum requirements
• 1 Strong organization and documenting skills
• 2 Proficiency with computers, Teams, Microsoft Outlook, experience with excel
• 3 Confidence to call parents and providers to resolve issues