SCO RN Care Manager Reading, Lynn, Revere, Bedford Chinese speaking

Job Summary

The Care Manager – Nursing Field (RN CM) will ensure that all members receive timely care management across the continuum, including transitions of care, care coordination and navigation, complex case management, population health and wellness interventions, and disease/chronic condition management per department guidelines. The RN CM works closely with the member, caregiver/authorized representative, and providers to meet targeted member‑specific goals, focusing on empowering the member to support optimal wellness and improved self‑management.

• Perform telephonic member outreach and/or face‑to‑face encounter utilizing key motivational interviewing skills to facilitate program enrollment.
• Perform departmental assessments and evaluate members holistically to identify needs, health goals, and barriers to wellness.
• Through assessment and collaboration with members/caregivers and providers, develop a member‑specific plan of care, implement targeted care manager interventions, and revise the plan as needed.
• Complete documentation in applicable platform according to departmental policy and regulatory standards.
• Provide targeted health education and proactive strategies for condition management, and communicate with key providers and vendors actively involved in the member’s care.
• Collaborate with members/caregivers and the facility care team to coordinate a safe transition to the next level of care, ensuring understanding of post‑hospital discharge instructions, facilitating needed services and follow‑up, and implementing strategies to prevent re‑admission.
• Collaborate and liaise with the interdisciplinary care team to improve member outcomes, including Utilization Management, Medical Director, pharmacy, community health workers, dementia care specialists, wellness, and Behavioral Health CM.
• Attend and present (as appropriate) high‑risk members at interdisciplinary rounds forums.
• Maintain professional growth and development through self‑directed learning activities.

Certification and Licensure:
Registered Nurse with a current unrestricted license in the state of residence; may be required to obtain additional state licensure in states where Point
32

Health operates.

Education:

Minimum Bachelor’s degree or relevant equivalent experience;
Bachelor’s degree in nursing preferred.

Experience:

Minimum 5 years of relevant clinical experience; preferred experience in home care or case management.

Additional:
Proficiency in a second language desirable; experience in specialty areas a plus.

• Skill and proficiency in Microsoft applications, technical concepts and principles; computer software applications.
• Work cooperatively as a team member across multiple levels within the organization.
• Skilled in assessment, planning, and managing member care.
• Advanced communication and interpersonal skills.
• Independent and autonomous with key job functions.
• Ability to address multiple complex issues.
• Flexibility and adaptability to a changing healthcare environment.
• Ability to organize and prioritize work and member needs.
• Demonstration of strong clinical and critical thinking skills.
• Regard for confidential data and adherence to corporate compliance policy.

Must be able to work under normal office conditions and from remote office as required. Work may involve simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations. Ability to make face‑to‑face visits (member home, provider practices, facilities) as needed. Valid driver’s license and vehicle in good working condition as travel is required. May be required to work additional hours beyond standard work schedule.

$87,092.51 - $

The annual base salary range provided represents a range of salaries for this role and similar roles across the organization. The actual salary will be determined by the scope and complexity of the role and the candidate’s skills, education, training, credentials, and experience. Colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation remains at the Company’s sole discretion.

• Medical, dental and vision coverage
• Retirement plans
• Paid time off
• Employer‑paid life and disability insurance with additional buy‑up coverage options
• Tuition program
• Well‑being benefits
• Full suite of benefits to support career development, individual & family health, and financial health

All applicants are welcome and will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.