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CommuniCare Advantage is seeking a Health Plan Care Manager for their Medicare Advantage plan in Martinsburg, WV. The ideal candidate should be a licensed RN or LSW with experience in care management, tasked with ensuring high-quality healthcare services for members in an institutional setting.
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Job Summary
The Care Manager will be responsible for coordinating member-care, developing actionable care plans, communicating effectively, and ensuring high-quality healthcare services are delivered to members in an institutional setting within a special needs plan (ISNP).
Perform initial, annual, transition of care (TOC) and change in condition health risk assessments (HRA) for ISNP care managed caseload.
Collaborate with the interdisciplinary team (ICT) which may include Medical Director, PCP, nurse practitioners/physician assistants, pharmacy, dietary, social workers, other clinical and non-clinical disciplines, facility staff, member representatives and family to establish, revise and continuously evaluate the member centric care plan.
Matching Summary
Match Score: 75
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CommuniCare Advantage is seeking a Health Plan Care Manager for their Medicare Advantage plan in Martinsburg, WV. The ideal candidate should be a licensed RN or LSW with experience in care management, tasked with ensuring high-quality healthcare services for members in an institutional setting.
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Skills & Requirements
Must-have
Medicare Advantage plan
ISNP members
interdisciplinary care team
documentation integrity
face to face visits
Nice-to-have
critical thinking
listen with compassion
strong ethical compass
emotional intelligence
work independently
Key Requirements
Licensed RN or LSW
Clinically licensed in state of employment
Certified Case Management (CCM) or willing to obtain