RNCareManager

**Job Description:** Select Health is a community health plan serving more than 1 million members. Select Health’s line of businesses include Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans, and fully funded and self-funded Commercial Employer plans. The Care Manager works with Select Health members, their family, caregivers, and a multi-disciplinary care team in a collaborative process of assessment, planning, facilitation, navigation, coordination, evaluation and advocacy in order for member to access benefits, resources, and services to meet comprehensive medical, behavioral, and social needs of members while promoting self-management, quality, and cost-effective outcomes. **Essential Functions** * The nurse care manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication, coordinates services, addresses barriers, and promotes optimal allocation of resources while balancing clinical quality and cost management. * This position is responsible for developing, documenting and implementing care plans, which will provide the appropriate resources to address social, physical, mental, emotional, spiritual, and supportive needs. * Identifies members unable to adhere to a medical plan or members that require complex additional assistance and enrolls and follows these members in longitudinal care management services. * Follows the applicable established model of care or care management program policies and procedures to assess, establish and maintain a plan of care which incorporates the member's individualized needs and goals within the benefit plan throughout the care management process. * Ensures the plan is evidence based and consistent with goals and objectives of referral, payer contract, or established care processes. * Ma