Case Manager - Registered Nurse
Stryker Corporation, Columbia, SC, United States
Job Summary
The Care Manager-Registered Nurse is a key member of the Special Needs Plan (SNP) care team, responsible for coordinating care for members with multiple chronic medical and behavioral health conditions and various social determinants of health (SDoH) needs. The role involves conducting comprehensive assessments, addressing SDoH challenges, connecting members with resources, and providing education and guidance on managing chronic conditions. The Care Manager develops individualized care plans, monitors member progress, advocates for necessary services, collaborates with an interdisciplinary team, documents interventions accurately, and participates in team meetings.
Key Responsibilities
50-75% of the day is dedicated to telephonic engagement with members and coordination of their care.
Compile all available clinical information and partner with the member to develop an individualized care plan that meets identified needs.
Provide evidence-based disease management education and support to help the member achieve health goals.
Ensure the appropriate members of the interdisciplinary care team are involved in the member's care.
Support seamless health care experience through care coordination.
Document care management activity meticulously in the member's electronic health record.
Collaborate with the Interdisciplinary Care Team to address barriers and develop strategies for maintaining stable health.
Identify and connect members with health plan benefits and community resources.
Meet regulatory requirements within specified timelines.
Support other Care Team members through clinical decision making and guidance as needed.
Perform additional responsibilities assigned by leadership to support team objectives, enhance operational efficiency, and ensure high-quality care delivery—such as participating in special projects, process improvement initiatives, or mentoring new team members.
Essential Competencies and Functions
Meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements.
Conduct oneself with integrity, professionalism, and self-direction.
Willingness to learn the role of care management within Medicare and Medicaid managed care.
Familiarity with community resources and services.
Navigate and utilize healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.
Maintain strong collaborative relationships with members and colleagues.
Communicate effectively, both verbally and in writing.
Provide excellent customer service and engagement skills.
Work Expectations
Access to a private, dedicated space to conduct work effectively.
Dependents must have separate care arrangements during work hours; continuous care responsibilities during shift times are not permitted.
Required Qualifications
Active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).
Confidence working at home / independent thinker, using tools to collaborate virtually.
3+ years of nursing experience.
2+ years of case management, discharge planning, and/or home healthcare coordination experience.
Preferred Qualifications
Experience providing care management for Medicare and/or Medicaid members.
Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.
Experience conducting health-related assessments and facilitating the care planning process.
Bilingual skills, especially English-Spanish.
Education
Associate’s degree in Nursing (ASN) and relevant experience (Required).
Bachelor’s degree in Nursing (BSN) (Preferred).
License
Active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
$54,095.00 - $116,760.00
Benefits
We offer a comprehensive benefits package that supports physical, emotional, and financial well‑being. This includes medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources, based on eligibility.
Equal Opportunity Employer Statement
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr
The Care Manager-Registered Nurse is a key member of the Special Needs Plan (SNP) care team, responsible for coordinating care for members with multiple chronic medical and behavioral health conditions and various social determinants of health (SDoH) needs. The role involves conducting comprehensive assessments, addressing SDoH challenges, connecting members with resources, and providing education and guidance on managing chronic conditions. The Care Manager develops individualized care plans, monitors member progress, advocates for necessary services, collaborates with an interdisciplinary team, documents interventions accurately, and participates in team meetings.
Key Responsibilities
50-75% of the day is dedicated to telephonic engagement with members and coordination of their care.
Compile all available clinical information and partner with the member to develop an individualized care plan that meets identified needs.
Provide evidence-based disease management education and support to help the member achieve health goals.
Ensure the appropriate members of the interdisciplinary care team are involved in the member's care.
Support seamless health care experience through care coordination.
Document care management activity meticulously in the member's electronic health record.
Collaborate with the Interdisciplinary Care Team to address barriers and develop strategies for maintaining stable health.
Identify and connect members with health plan benefits and community resources.
Meet regulatory requirements within specified timelines.
Support other Care Team members through clinical decision making and guidance as needed.
Perform additional responsibilities assigned by leadership to support team objectives, enhance operational efficiency, and ensure high-quality care delivery—such as participating in special projects, process improvement initiatives, or mentoring new team members.
Essential Competencies and Functions
Meet performance and productivity metrics, including call volume, successful member engagement, and state/federal regulatory requirements.
Conduct oneself with integrity, professionalism, and self-direction.
Willingness to learn the role of care management within Medicare and Medicaid managed care.
Familiarity with community resources and services.
Navigate and utilize healthcare technology tools to enhance member care, streamline workflows, and maintain accurate records.
Maintain strong collaborative relationships with members and colleagues.
Communicate effectively, both verbally and in writing.
Provide excellent customer service and engagement skills.
Work Expectations
Access to a private, dedicated space to conduct work effectively.
Dependents must have separate care arrangements during work hours; continuous care responsibilities during shift times are not permitted.
Required Qualifications
Active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams).
Confidence working at home / independent thinker, using tools to collaborate virtually.
3+ years of nursing experience.
2+ years of case management, discharge planning, and/or home healthcare coordination experience.
Preferred Qualifications
Experience providing care management for Medicare and/or Medicaid members.
Experience working with individuals with SDoH needs, chronic medical conditions, and/or behavioral health.
Experience conducting health-related assessments and facilitating the care planning process.
Bilingual skills, especially English-Spanish.
Education
Associate’s degree in Nursing (ASN) and relevant experience (Required).
Bachelor’s degree in Nursing (BSN) (Preferred).
License
Active and unrestricted Compact Registered Nurse (RN) licensure in the state of residence.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
$54,095.00 - $116,760.00
Benefits
We offer a comprehensive benefits package that supports physical, emotional, and financial well‑being. This includes medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources, based on eligibility.
Equal Opportunity Employer Statement
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr