RN Care Manager

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5 days old

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The salary range for this role is $64,000 - $87,000

Actual base pay will be determined based on a successful candidate's work location, skills/abilities, experience, and education. This role includes opportunity to receive an annual bonus target of 5% of annual eligible earnings. Actual bonus amounts are determined by length of time in role, individual performance, and organizational performance.

Candidates must be willing and able to work onsite at least 3 days per week in our Melbourne, FL office. 

This is a full-time position, Monday - Friday from  8:00 a.m. - 5:00 p.m.  

Who We Are

At Christian Care Ministry (CCM) we believe that Christians can, and should, share in one another’s burdens. Through the use of Medi-Share®, a healthcare sharing ministry for Christians, we cultivate that belief.

The Team

Everyone at Christian Care Ministry agrees to our Statement of Faith which outlines our core beliefs. Although we aren’t perfect people, we are serving our perfect God to the best of our ability.

The Role

The RN Care Manager serves as the key point of contact and coordinator of care to members experiencing an acute, catastrophic, 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 Sr. Director, Clinical Services
  • 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
  • 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

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
  • 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 regularly.
  • 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

  • Collaborates – builds partnerships and works collaboratively with others to meet
  • Manages Conflict – handles conflict situations effectively. This role requires patiently and respectfully accepting and responding to members and providers who do not agree with the determinations presented to them
  • Interpersonal Savvy – relates openly and comfortably with a diverse group of people. Must be able to communicate effectively and build engagement across all audiences
  • Drives Results – consistently achieves results even under tough circumstances
  • Situational Adaptability – adapting approach and demeanor in real time to match the shifting demands of different
  • Courage – ability to have tough conversations and deliver accurate advice and decisions
  • Forward Thinking – the ability to anticipate the implications and consequences of situations and take appropriate action to be prepared for possible contingencies
  • Initiative – identifying what needs to be done with a willingness to take action

Education and/or Experience

  • Registered nurse with a current unrestricted multi-state compact license or willingness to pursue
  • Bachelor of Science in Nursing (strongly preferred) or health-related field (required) 
  • Cardiovascular, Medical/surgical, orthopedic, pediatrics, and/or transplant clinical experience required
  • 3+ years nursing experience required; acute and catastrophic care highly preferred
  • 2+ years of case management and/or utilization management and transitional care/discharge planning experience
  • Have or willing to obtain a certification in either case management or managed care nursing within two years

Incentives & Benefits

We work hard to serve our 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.

Employees are eligible to receive annual incentive pay based on individual and organizational performance.

 

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
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