RN Care Manager

RN Care Manager

Melbourne, FL | Orlando, FL | Hybrid

The range for this role is $74,500 - $101,500. Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education. Interested applicants must be willing and able to work onsite minimum 4 times per week in either our Melbourne, FL or Orlando, FL office.

The Job

The RN Care Manager serves as the key point of contact and coordinator of care to members experiencing an acute, catastrophic, chronic, or costly health care event. The RN Care Manager assists members and their providers in best navigating and utilizing the Medi-Share provisions and provider network for improved clinical outcomes, clinically substantiated courses of treatment, timely and improved access to cost-effective care, and greater member satisfaction.

Essential Job Duties & Responsibilities

• Performs within licensed scope of nursing practice and under the direction of the Chief Medical Director
• Identifies, screens, and enrolls members meeting criteria into Care Management Services
• Educates members and providers (as appropriate) regarding the Medi-Share provisions and processes
• Confirms member's condition and plan of care are eligible for sharing based on Medi-Share and FDA/CMS approved evidence-based clinical management guidelines; suggests resources for those conditions/plan of care not eligible for sharing
• Identifies, educates, and facilitates member participation in appropriate member stewardship including, but not limited to patient assistance programs for medication, laboratory, and genetic testing
• Provides disease/condition specific clinical education to include multimedia resources, if available
• Utilize professional coaching skills (appreciative inquiry, motivational interviewing, and change management) with members to facilitate improved clinical outcomes
• Identifies opportunities for and facilitates transitional care
• Partners with organizational resources to facilitate effective and cost-efficient outcomes for members
• Delivers accurate and comprehensible verbal and written communication to external customers while complying with organizational HIPAA requirements
• Documents case work, all telephone conversations, correspondence, and tasks completely and accurately in appropriate IT systems
• Maintains and independently manages assigned caseload and departmental workflows within agreed service levels
• Presents accurate, complete, and concise case information to Sr. Director, Clinical Services within agreed upon service levels
• Completes medically related special projects independently as assigned with minimal supervision
• Attends all required departmental and organizational meetings
• Prays with members and providers as appropriate
• Contributes to the exercise and expression of the Ministry's Christian beliefs
• Performs all other duties as assigned

Essential Skills & Abilities

• Expert knowledge of all Medi-Share program guidelines and processes
• Excellent ability to communicate effectively with internal and external customers of all types in written, oral, telephonic, and digital formats that build engagement, interest, and facilitate positive outcomes
• Ability to utilize appreciative inquiry, motivational interviewing and other similar coaching skill to influence behavior change
• Excellent researching, analytical, and critical-thinking skills
• Advanced planning and organizational skills; works effectively without supervision
• Advanced skill with Microsoft Office (Word, Excel, Outlook)
• Excellent computer skills ability to access, research and use multiple software programs simultaneously and keyboard skills of at least 35 words per minute
• Ability to collaborate effectively and professionally with interdisciplinary team members, members/patients, families, providers, facilities and other employees and departments
• Ability to comply with HIPAA and PHI requirements and all call compliance rules and regulations
• Strong ability to work independently and with a team
• Ability to handle conflict situations effectively
• Strong ability to adapt to changing processes
• Excellent ability to provide all content within a biblical framework

Core Competencies/Demonstrable Behaviors

• Manages Complexity making sense of complex, high quantity, and sometimes contradictory information to effectively solve problems
• Situational Adaptability adapting approach and demeanor in real time to match the shifting demands of different situations
• Courage ability to have tough conversations and deliver accurate advice and decisions
• Member First exhibits full commitment to serving members and/or clients by prioritizing their needs first in alignment with our program's purpose. This commitment is demonstrated through understanding of the program(s), provided through quality and timely service while exercising empathy in every interaction. Every CCM employee shares responsibility to steward resources faithfully, removing barriers to understanding, and creating accessible, connected, and Christ-centered experiences.
• Humble demonstrates Christ-Centered humility by honoring others, accepting feedback, and prioritizing collective success over individual recognition
• Hungry exhibits initiative, perseverance, and commitment to serving God through excellence. Demonstrates passion for personal and organizational growth while diligently advancing the mission of Christian Care Ministry
• Smart shows relational and emotional intelligence, communicates effectively, collaborates harmoniously, and reads social cues with grace and discernment

Education and/or Experience

• Registered nurse with a current unrestricted multi-state compact license or willingness to pursue required
• Bachelor of Science in Nursing preferred
• 3+ years nursing experience required, acute and catastrophic care highly preferred
• 2+ years of case management and/or utilization management required
• Adult Oncology experience a plus
• Transitional care and transplant clinical experience highly preferred
• Have or willing to obtain a certification in either case management or managed care nursing within two years if applicable

Supervisory Responsibilities

• This job has no supervisory responsibilities

Incentives & Benefits

We work hard to serve our Medi-Share Members, but know we can only do that if we invest in our employees professionally, financially, physically, socially, and spiritually. We purposefully invest in our employees so that our employees can invest in others.

For full-time employees working 30 hours or more, some of our benefits include, but are not limited to:

• 100% paid Medical for employees/99% for family
• Generous employer Health Savings Account (HSA) contributions
• Employer-paid Life Insurance (3x salary) and Long-term Disability Insurance
• 6 weeks of paid parental leave (for both mom and dad)
• Dental - two plans to choose from
• Vision
• Short-term Disability
• Accident, Critical Illness, Hospital Indemnity
• 401(k) up to 4% match on ROTH or Traditional contributions
• Generous paid-time off and 11 paid holidays
• Wellness plan including Financial, Occupational, Mental/Spiritual, and Physical health incentives up to $50/mo
• Employee Assistance Program including no cost, in-person mental health visits and employee discounts
• Monetary Anniversary Awards Program
• Monetary Birthday Awards
• Tuition Reimbursement Program

Minimum Age Requirement: Due to the nature of the responsibilities associated with this positionincluding independent decision-making, access to confidential information, and potential exposure to regulated environmentscandidates must be at least 18 years of age at the time of hire. This requirement is in accordance with applicable federal and state labor laws and is intended to ensure compliance with workplace safety and legal standards.