Belong Health
Healthcare
RNCareManager(DSNP)
Neural analysis suggests this role is
optimal for Mid+ candidates.
“RN Care Manager (DSNP) at Belong Health. Skills: Care management, Member-centered care, Health plan operations. Provide clinical oversight to Medicare beneficiaries. Orient new members to program”
What You'll Achieve.
Ensure timely and satisfactory resolution of customer issues
Industry & Context.
Problem solve effectively; Problem solve efficiently
Some travel required, Semi-annual onsite meet ups
What They're Looking For.
Must Have
Active, unrestricted nursing license in NY (RN), Graduate of accredited nursing program, Associate Degree in Nursing (ADN) or Bachelor of Science in Nursing (BSN), Two (2) or more years’ experience in health plan, health care organization, Community Based Organization, or social services environment, Experience supporting Medicare, Medicare Advantage, Medicaid, Dual Eligible Special Needs Plans (DSNP), or other complex populations, Experience delivering care management services in telephonic and/or virtual environment, Demonstrated ability to manage caseload of medically and socially complex members, Ability to work independently and effectively within a fully remote and highly collaborative team environment
Nice to Have
Demonstrated experience in managed care, Medicare Advantage, DSNP, or value-based care environment, Care Management Certification preferred (CCM, ACM, CMGT-BC, or equivalent), Bachelor of Science in Nursing (BSN) preferred, Bi-lingual Spanish speaking preferred
What You'll Do.
Provide clinical oversight to Medicare beneficiaries
Orient new members to program
Educate member and/or caregivers on services
and educate beneficiaries on self-management
Conduct assessments to identify barriers
Complete health risk assessments
Identify members requiring intensive care management
behavioral health and community-based services
Develop and implement individual care plan
Monitor member progress toward goals
Revise interventions based on needs
Lead interdisciplinary care team meetings
Collaborate with providers
Coordinate care and achieve care plan goals
Support transitions of care activities
Perform post-discharge outreach
Provide medication reconciliation support
Coordinate with providers and caregivers
Document all care management activities
families and/or advocates
Work with providers and community service organizations
Coordinate care and reduce barriers
Utilize population health platforms
Utilize risk stratification platforms
Utilize care management technology platforms
Prioritize outreach and interventions
Promote culture of accountability and performance
Meet and exceed personal service vision goals
Ensure timely and satisfactory resolution of customer issues
Perform other duties as assigned
How You'll Work.
Team & Collaboration
Provider practices; Community-based organizations; Caregivers; Belong Health team; Interdisciplinary care team; Social workers; Discharge planners; Cross departmental projects
Communication Scope
Oral communication skills; Written communication skills; Presentation skills
Process & Methodology
Policy and procedure changes, Coordination of activities and initiatives
Full Job Description
Hello, we’re Belong. We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products. With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long. We believe that only by recognizing individuals can we make communities strong. Belong Health. Kinder, more supportive care. SUMMARY The Registered Nurse (RN) Care Manager for Belong Health's DSNP program is responsible for providing comprehensive, member-centered care management services for Medicare beneficiaries with complex medical, behavioral health, and social needs. This role applies care management principles to assess member needs, develop and implement individualized care plans, coordinate services across the continuum of care, and maintain collaborative relationships with provider practices, community-based organizations, caregivers, and the Belong Health team. ESSENTIAL JOB DUTIES AND RESPONSIBILITIES Responsible for providing clinical oversight to medically complex Medicare beneficiaries Orient new members to the Belong Health DSNP program and educate the member and/or caregivers on care management services. Advocate, empower, inform, and educate beneficiaries on self-management techniques. Conduct assessments to identify barriers and opportunities for intervention. Complete health risk assessments, reassessments, and other clinical evaluations in accordance with program requirements. Identify members requiring intensive care management interventions and coordinate appropriate clinical, behavioral health and community-based services. Develop and implement an individual care plan (ICP). Monitor member progress toward care plan goals and revise interventions based on changing clinical or social needs. Lead interdisciplinary care team meetings. Collaborate with provider
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