Care Manager I (RN)
Company: Sunshine State Health Plan
Location: Saint Cloud
Posted on: January 16, 2022
Position Purpose:Perform care management duties to assess, plan
and coordinate all aspects of medical and supporting services
across the continuum of care for select members to promote quality,
cost effective care
Develop, assess and adjust, as necessary, the care plan and promote
Assess the member's current health status, resource utilization,
past and present treatment plan and services, prognosis, short and
long term goals, treatment and provider options
Coordinate services between Primary Care Physician (PCP),
specialists, medical providers, and non-medical staff as necessary
to meet the complete medical socio economic needs of clients
Develop plan of care based upon assessment with specific
objectives, goals and interventions designed to meet member's
Provide patient and provider education
Facilitate member access to community based services
Monitor referrals made to community based organizations, medical
care and other services to support the members' overall care
Actively participate in integrated team care management rounds
Identify related risk management quality concerns and report these
scenarios to the appropriate resources
Enter and maintain assessments, authorizations, and pertinent
clinical information into various medical management systems
Hours: 8:30am-5pm with 1 hour lunch from 12-1pm.
- Department: Children's Medical Services
- Caseload: Pediatrics - Newborn to 21-year olds. Caseload of 40
- Territory: Osceola County primarily. Can consider applicants
that reside in Orange or Seminole Counties, too. Field/Local travel
typically within county within 60 mile radius. Must reside in or be
willing to relocate to the above mentioned area of Florida. Travel
will be 75%.
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work
schedules and dress flexibility
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and
Education/Experience:Graduate from an Accredited School of Nursing.
Bachelor's degree in Nursing preferred. 2+ years of clinical
nursing experience in a clinical, acute care, or community setting.
Knowledge of healthcare and managed care preferred.
Licenses/Certifications: Current state's RN license.
For Sunshine Health (FL) Only: Employees supporting Florida's
Children's Medical Services (CMS) must have a minimum of two years
of pediatric experience.
Keywords: Sunshine State Health Plan, Melbourne , Care Manager I (RN), Executive , Saint Cloud, Florida
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