Hybrid RN Care Manager (Bedford, NH)

Your Future is our Future

At Lumeris, we believe that our greatest achievements are made possible by the talent and commitment of our team members. That's why we are actively seeking talented and collaborative individuals who are passionate about making a difference in the healthcare industry. Join us today as we strive to create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact.

We're excited to consider every qualified candidate authorized to work in the United States, although we are unable to sponsor visas for this role at this time.

Position Summary

Provides telephonic care and case management to Medicare members as part of a multidisciplinary care team. Offers members education, empowerment and consultation to help improve member care. Collaborates with care team to ensure there are no gaps in care. Collaborates with members, providers, and care givers to ensure positive care outcomes during care transitions.

Primary Responsibilities

• Offers members health and disease education and empowers them to regularly participate in their care. Encourages members to make healthy lifestyle changes.
• Provides consultation to members on their medications and durable medical equipment.
• Reviews member care plans, addresses home care needs, and connects members to community resources.
• Makes outbound calls to assess member's current health status.
• Provides patient education and use Motivational Interviewing to assist with self-management.
• Creates and monitors personalized member plans of care.
• Educates members on disease processes.
• Identifies gaps or barriers in treatment plans.
• Coordinated care for members.
• Makes referrals to outside sources.
• Coordinates services such as home health, DME, as needed.
• Ensures that discharged members receive the necessary services and resources, including medication reconciliation.
• Documents and tracks findings in a computerized system.
• Interacts with providers and a multi-disciplinary care team.
• Collaborates with medical management staff in development of new programs.
• Remains committed to member and department success and works to assist the team in meeting goals.
• Trains and mentors new employees.

Qualifications

• Current licensure in good standing as a registered nurse in the state of New Hampshire and eligibility for licensure in other states
• 5+ years of clinical nursing experience including 2+ years of experience in a hospital or home health case management setting or the knowledge, skills, and abilities to succeed in the role
• Ability to take and pass case management certification (CCM) within 2 years of hire and to maintain CCM certification during employment
• Proficient computer skills with the ability to learn and apply new technologies
• Ability to type and talk simultaneously
• Considerable initiative and ability to prioritize workload and respond to changing demands/timelines
• Ability to guide team projects or processes
• Strong judgement and critical thinking skills with a proven ability to assess member needs and develop a plan of care
• Flexible and adaptive to a changing environment
• Effective communication and relationship building skills with the ability to influence and positively impact members
• Excellent interpersonal and customer service skills, including telephone etiquette
• Effective training and mentoring skills

Preferred

• BSN or experience with telephonic case management
• Case management certification
• Previous experience as a telephonic case manager for a Medicare insurance plan

Working Conditions

• While performing the duties of this job, the employee works in normal office working conditions.

Additional information

*If you receive an offer of employment, you will be required to provide proof of updated vaccinations and complete a pre-employment drug screen.

#LI-Hybrid

Pay Transparency

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. In addition to the base salary, certain roles may qualify for a performance-based incentive and/or equity, with eligibility depending on the position. These rewards are based on a combination of company performance and individual achievements.

The hiring range for this position is: $84,600.00-$113,775.00

Benefits of working at Lumeris

• Medical, Vision and Dental Plans
• Tax-Advantage Savings Accounts (FSA & HSA)
• Life Insurance and Disability Insurance
• Paid Time Off (PTO, Sick Time, Paid Leave, Volunteer & Wellness Days)
• Employee Assistance Program
• 401k with company match
• Employee Resource Groups
• Employee Discount Program
• Learning and Development Opportunities
• And much more...

• Be part of a team that is changing healthcare!
• Member Facing Position: No- Not Member or Patient Facing Position

Drug Screen Requirement

• No
• MVR Required: No
• Credit Check Required: No
• Location: New Hampshire
• Time Type: Full time

Additional information

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.