Behavioral Health​/Substance Use Nurse Care Manager, Adult

Overview

We re looking for Nurse Care Managers for our Care and Case Management team, who are passionate about caring for members holistically through their healthcare journey and ensuring needs are met with industry-leading interventions. As a telephonic Nurse Care Manager you will report to the Manager, Care and Case Management and will guide members through complex medical and behavioral health situations, partnering with a diverse clinical team that includes a variety of healthcare professionals, care coordinators, and records specialists to deliver integrated remote care in a creative way.

This role focuses specifically on members with behavioral health and substance abuse or substance abuse disorder needs, requiring experience with complex psychiatric and substance abuse disorders. The Nurse Care Manager should enjoy spending time on the phone, listening to members  needs, answering questions, and serving as an advocate. You will excel at creating cohesive care plans, and have the clinical skills to guide members clinically and navigate available benefits and resources.

Nurse Care Managers will support members through complex care management, disease management, and acute case management, ensuring they receive longitudinal care that results in excellent health outcomes.

#LI-Remote

• Deliver coordinated, patient-centered virtual Care Management by telephone or video that improves members  health outcomes.
• Create impactful care plans together with members and our diverse care team, and help members achieve the desired goals.
• Help members navigate complex medical conditions, treatment pathways, benefits, and the healthcare system in general.
• Partner with the members  local providers to ensure coordinated care.
• Provide compassionate, longitudinal follow-up care, building supportive relationships.
• Assist throughout acute healthcare episodes, such as hospitalizations and rehabilitation stays, providing coordinated Case Management to support the member and their family.
• Coordinate necessary resources that holistically address members  problems, whether clinical or social

• Bachelor of Science in Nursing (BSN).
• Current CCM required
• 5+ years of experience in nursing
• 2+ years experience working in care, case and disease management, preferably in a health plan, health navigator or third party administrator (TPA) environment.
• 2+ years experience working in Behavioral Health and or substance use field
• Must reside in a compact NLC state.
• Active Compact RN license in good standing with the nursing board of their state.
• Active California Nursing License preferred.
• Willingness to become (and maintain) licensure in multiple states.
• Work until 9-6PM PST
• Be comfortable discussing several medical conditions and experience with populations across the age ranges
• Spanish speaking desirable
• Experience working remotely, and strong competence and ability to use multiple computer/medical record systems.
• Be empathetic. We work with patients and their families who are going through challenging times. You practice empathy and reassure patients that we are available to help them.
• We are a fast-growing company and we are busy. Our team will meet volume goals without sacrificing quality.
• Strictly follow security and HIPAA regulations to protect our patients  medical information.
• Be pleasant, responsive, and willing to work with and learn from our team.
• A lot of time is spent on the phone with patients and families, and a lot of time communicating with colleagues. Therefore, the ability to gather a clinical history, answer questions at a patient level, and summarize findings is critical.
• Efficient at writing medical information in easy-to-understand, patient-centric language.

• Prompt and regular attendance at assigned work location.
• Capability to remain seated in a stationary position for prolonged periods.
• Eye-hand coordination and manual dexterity to operate keyboard, computer and other office-related equipment.
• No heavy lifting is expected, though occasional exertion of about 20 lbs of force (e.g., lifting a computer / laptop) may be required.
• Capability to work with leadership, employees,…