RN Care Manager
Company: Wellvana Integration Partners, LLC
Posted on: November 15, 2023
The healthcare system isn't designed for health. We're designed
to change that. We're Wellvana, and we help doctors deliver
life-changing healthcare. Through our elevated value-based care
programs, we're revitalizing an antiquated system that's far too
long relied on misaligned incentives that reward quantity of care
not the quality of it. Our enlightened approach-covering everything
from care coordination to coding to marketing- ties the healthy
outcomes of patients directly to healthier earnings for primary
care providers. Providers in our curated network keep their
independence, reduce their administrative headaches, and spend more
time with patients. Patients, in turn, get an elevated experience
with coordinated 24/7 care that is nothing short of life changing.
Recently named by Insider as one of 33 startups investors expect to
take off in 2023, we're one of the fastest-growing healthcare
companies in America because what we do works. This is the way
medicine is meant to be.The Role: We're looking for a Registered
Nurse with a compact license who embraces change and is not afraid
of a challenge. The RN Care Manager is responsible for managing
rising risk and high-risk members to promote effective education,
self-management support, and timely healthcare delivery to achieve
optimal quality and financial outcomes. The RN Care Manager will
formulate and implement a care management plan that addresses the
members identified needs by assessing concerns/barriers, resources,
and care goals. The RN Care Manager will advocate for the member
and support the member in navigating the health care system via
ongoing engagement. When applicable, the RN Care Manager will work
collaboratively with the interdisciplinary care team and the
member's primary care provider to identify and support the
achievement of the member's short-term and long-term health goals.
The RN Care Manager provides education and resources to members
and/or responsible parties, to reduce preventable emergency room
visits, hospitalizations, and re-admissions. What you'll do:
- Uses analytics and practitioner referrals in identifying
appropriate members for care management, utilizing established care
- Utilizing different technologies and/or telephonically engages
members recently discharged from emergency department and acute
inpatient stays and who are at elevated risk for admission and
- Collaborates as needed with providers, and other healthcare
team members including inpatient care management staff and
outpatient providers, to transition and facilitate care across the
healthcare continuum to optimize clinical and financial
- Cooperates with appropriate health care team members to perform
root cause analysis on readmissions.
- Provides insights and recommendations for hospice and
palliative eligible patients.
- Performs initial and periodic whole-person assessments for
identified individuals. This includes physical, social determinants
of health, and psychological barriers and concerns for members as
- Formulates and implements a member-centric care management
plan, utilizing SMART goals, that address practitioner care goals,
member/family concerns and available resources.
- Provides ongoing evaluation of the effectiveness of the plan of
care in meeting established care goals through collaboration with
the healthcare team, member and/or family-caregivers.
- Revises the plan of care as needed to reflect changing needs,
issues and goals and monitors and evaluates the progress of the
member at prescribed minimal intervals.
- Identifies and effectively utilizes community resources to meet
the needs of members/families.
- Facilitates member access to community resources as
- Maintains accurate and timely documentation. Ensures
documentation meets current standards and policies.
- Strives to meet established goals for productivity.
- Participates in regular team meetings and peer review
activities. Participates in departmental and organizational
committees, as applicable. Assists/supports in the orientation of
new personnel. Promotes collaborative teamwork.
- Meets with care management leadership team and the care
management/clinical coordination team on a regular basis to provide
member updates identify issues and develop strategies for
- Maintains appropriate professional boundaries.
- Maintains a working knowledge of, and adheres to applicable
federal and state regulations including, but not limited to, laws
related to patient confidentiality, the release of information, and
- Interacts respectfully and effectively with others, focusing
upon the achievement of organizational goals and objectives through
a commitment to teamwork.
- Abides by the organization's compliance program and
- Maintains appropriate clinical licensure in good standing.
- Prioritizes caseload to balance member and departmental
- Utilizes motivational interviewing techniques to engage members
in goal setting.
- Identifies problems or gaps in care and offers opportunity for
- Considers teaching methods based on individual
- Appropriately updates departmental leadership with necessary
- Supports training of new telephonic staff members.
- Performs other duties as needed. Education
- Associates degree in nursing required
- BSN Preferred Licensure/Certification
- Must hold a current/active Florida RN license Required
- Five years of nursing-related care experience
- Case Management, Care Management, Care Coordination, telephone
nursing management, and/or Disease Management experience Required
Knowledge, Skills, and Abilities
- Knowledge of care management concepts along the continuum of
- Advanced clinical knowledge of chronic disease states
- Motivational and behavioral interviewing
- Experience and ability to use Microsoft Office products and
word-processing software daily
- Excellent written, verbal, and listening communication
abilities. Communicate appropriately and clearly to members,
coworkers, and providers
- Ability to manage conflict, stress, and multiple simultaneous
work demands in an effective and professional manner
- Ability to successfully articulate the process of attaining
goals and outcomes of care management
- Ability to apply clinical knowledge and experience in a care
- Ability to care to manage diverse populations without applying
one's own personal values
- Ability to think critically and analytically and work with
minimal supervision within the nursing scope of practice.
- Ability to evaluate and appropriately respond to verbal and
non-verbal communication from patients in diverse stages of
Keywords: Wellvana Integration Partners, LLC, Orlando , RN Care Manager, Executive , Orlando, Florida
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