Family Care, Registered Nurse

• Manage each member's case within the scope of RN licensure
• Develop, monitor, evaluate, and revise person-centered member care plans
• Perform telephonic and face-to-face functional assessments
• Identify, evaluate, coordinate, and manage physical health, behavioral health, social services, and long-term support needs
• Identify members at risk for complications and coordinate care with members and healthcare teams
• Manage members with chronic illnesses, co-morbidities, and/or disabilities to support efficient utilization of health benefits
• Obtain member histories and establish short- and long-term goals with members, caregivers, families, natural supports, and physicians
• Identify members who may benefit from alternative levels of care or waiver programs
• Ensure members' access to required services
• Facilitate service authorizations and referrals within the benefits structure or through permissible extra-contractual arrangements
• Collaborate with Medical Directors, Physician Advisors, and interdisciplinary teams on care management and person-centered plans
• Help resolve provider, claims, and service issues
• Travel to worksites and other locations, including members' homes and communities, for in-person visits

• Associate of Science in Nursing or Bachelor of Science in Nursing, or equivalent combination of education and experience
• Minimum 3 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role
• Current, active, valid, and unrestricted RN license in Wisconsin required
• Minimum 1 year of experience working with at least one Family Care target population
• BA/BS in Health/Nursing preferred
• Case management experience with older adults or individuals with disabilities strongly preferred
• Long-term care background preferred
• Family Care/Partnership experience preferred
• Comfortable using technology preferred
• Strong interpersonal and communication skills
• Ability to work collaboratively in a team environment
• Problem-solving and crisis-management abilities
• Ability to travel to worksites and members' homes/communities for in-person visits
• Must meet applicable vaccination requirements for certain patient/member-facing roles, unless an acceptable explanation is provided

Demonstrates expertise in case management and care coordination for individuals with chronic illnesses and disabilities, ensuring access to necessary services and support. Proficient in developing and revising person-centered care plans while collaborating with interdisciplinary teams.

• RN License in Wisconsin
• Case Management Experience
• Experience with Chronic Illnesses
• Interpersonal and Communication Skills
• Ability to Travel for In-Person Visits

• Case Management
• Functional Assessments
• Care Plan Development
• Chronic Illness Management
• Service Coordination

• Problem-Solving Abilities
• Crisis Management
• Team Collaboration

• Associate of Science in Nursing
• Bachelor of Science in Nursing

• Long-Term Care
• Family Care
• Behavioral Health
• Social Services
• Healthcare Teams

• Telephonic Communication
• Technology Utilization