RN Care Manager

Engage with the enrollee in their homes and other community settings to establish an effective, complex care management relationship Function as a liaison between healthcare providers, community resources, and enrollees to ensure seamless communication and care transitions Perform required assessments on a timely basis, including but not limited to Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments Engage enrollees in care plan development and implementation Lead the interdisciplinary care team (ICT) and collaborate with peers both internal and external to the organization Oversee enrollee utilization of long‑term services and supports Assist members in accessing community resources, including housing, transportation, food assistance, and social services Educate members about their benefits and available services under both Medicare and Medicaid Follow up with members after hospitalizations or significant health events Work closely with primary care physicians, specialists, and other healthcare providers Requirements Associates of Science (A.S) degree in nursing from an accredited nursing program required A Registered Nurse with the ability to independently serve people with complex medical, behavioral, and social needs. required Prior experience in care coordination, case management, or working with dual‑eligible populations preferred Medicaid and/or Medicare managed care experience preferred Clinical Field/ Community Based Training a Plus Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel. Understanding of Medicare and Medicaid programs, as well community resources and services available to dual‑eligible beneficiaries. Strong interpersonal and communication skills to effectively engage with members, families, and healthcare providers Strong customer service skills Must have valid driver's license, vehicle and verifiable insurance. Core Competencies Demonstrates expertise in care coordination and case management for dual‑eligible populations, with a strong understanding of Medicare and Medicaid programs. Capable of leading interdisciplinary teams and effectively engaging with enrollees to facilitate access to community resources and services. Highest-signal resume keywords Registered Nurse Care Coordination Medicaid Experience Medicare Experience Interpersonal Communication ATS Optimization Keywords Hard Skills Care Management Comprehensive Assessment MDS-HC Functional Assessment Crisis Assessment Risk Assessment Soft Skills Strong Customer Service Effective Engagement Interpersonal Skills Certifications & Qualifications Associates of Science in Nursing Industry Keywords Dual‑Eligible Populations Community Resources Long‑Term Services and Supports Healthcare Providers Interdisciplinary Care Team Tools & Technologies Microsoft Office Outlook Word Excel #J-18808-Ljbffr