Capital Blue Cross

At Capital Blue Cross, we promise to go the extra mile for our team and our community. This promise is at the heart of our culture, and it’s why our employees consistently vote us one of the “Best Places to Work in PA.” We recognize that work is a part of life, not separate from it, and foster a flexible environment where your health and wellbeing are prioritized. At Capital, you will work alongside a caring team of supportive colleagues and be encouraged to volunteer in your community. We value your professional and personal growth by investing heavily in training and continuing education, so you have the tools to do your best as you develop your career. And by doing your best, you’ll help us live our mission of improving the health and well-being of our members and the communities in which they live.

RN Care Manager – Maternity

ManagerManagerFull TimeRemoteTeam 1,001-5,000Since 1938H1B SponsorCompany SiteLinkedIn

Location

Pennsylvania

Posted

25 days ago

Salary

$28 - $53 / hour

Professional Certificate3 yrs expEnglish

Job Description

• The Care Manager is responsible for the coordination of services for members who meet established criteria, with an emphasis on education/self-management and promoting quality care and cost-effective outcomes. • The Care Manager uses a collaborative process to assess Member needs, review options for services and resources, develop and implement a plan of care, coordinate resources, monitor progress, evaluate Member status, discharge Members, and fully document the individualized member care management process and outcome. • The Care Manager will address medical, psychosocial, clinical needs, and behavioral health needs including members with mental health and substance use disorder needs. • Care Managers provide counseling and referrals to community/local/state programs; collaborate with caregivers, providers, community agencies, behavioral health, and other resources to coordinate care to achieve member’s optimal health status. • The Care Manager is responsible for the management and oversight of a caseload of moderate - high risk Members with complex medical/behavioral /psychosocial needs.

Job Requirements

  • Registered Nurse with active licensure in home state; additional state’s licensure as needed/required to meet customer needs
  • Certified Case Management certification within 2 years of employment
  • At least three (3) years’ recent/related experience; care management, home health, medical/surgical behavioral health, and/or critical care preferred
  • Knowledge of NCQA standards for Population Health Management for health plan accreditation
  • Knowledge of evidence-based guidelines for chronic conditions/care management
  • Ability to operate a personal computer (PC), including proficiency in Microsoft Office Products.

Benefits

  • Medical, Dental & Vision coverage
  • Retirement Plan
  • Generous time off including Paid Time Off
  • Holidays
  • Volunteer time off
  • Incentive Plan
  • Tuition Reimbursement
  • More

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