Clinical - Care Manager; RN

Position Title

Care Manager (RN)

Remote-FL- anywhere in the state (in case someone has an issue with internet or needs IT help, they must go to a welcome center to resolve issues)

6+ months

8-5 M-F

Remote

Review and prioritize new referrals received daily in Tru Care, conduct timely telephonic outreach to eligible members, explain care management services and obtain member participation. Complete assessments, identify barriers to care, develop individualized care plans, coordinate services, provide disease-specific education, encourage completion of annual wellness exams, screenings, immunizations, elevate urgent concerns, maintain accurate and timely documentation. Care managers are expected to have an active caseload of 75 or higher, conduct 400 calls per month.

Our Care Managers serve as the primary advocate, educator, coordinator, and problem-solver for complex Medicaid members. This role offers a unique opportunity to impact member health outcomes at both the individual and population level by addressing medical needs, behavioral health concerns, social determinants of health, and preventive care opportunities.

Education/Certification Required: ASN Preferred: BSN Licensure Required: RN Preferred:
Years of experience required: 1 year of nursing experience and case management preferred

Disqualifiers: low comfort with technology, inability to work independently, poor communication skills, difficulty managing multiple priorities

Additional qualities to look for:
Our Care Managers are the hub of member-centered care. They combine clinical expertise, care coordination, health coaching, quality improvement, and social resource navigation to help Medicaid members achieve better health outcomes. This is a highly autonomous role that requires critical thinking, strong communication skills, and a passion for improving the health of underserved populations through whole-person care.

• Top 3 must-have hard skills stack-ranked by importance
• 1 Clinical assessment and critical thinking skills
• 2 Member engagement and communication skills
• 3 Time mgmt. and organization skills