Chronic Care Manager (RN) Onsite

Position Summary The Chronic Care Case Manager is a Registered Nurse who provides case management, education and outreach services telephonically to Medicare members in the Chronic Case Management Program.

This position requires licensure as a Registered Nurse in the State of Florida, compact licensure required.

This is a remote position.

Essential Duties and Responsibilities Fulfills requirements established by Community Health Solutions to complete monthly contacts with enrolled members.

Ensuring the information contained in the system of record is accurate and complete.

Provides members with education required to achieve optimal health maintenance and arranges appropriate education services, if necessary.

Develops case specific care plans.

Collaborate with the Care Advocate Team to ensure all required services, communications, documentation, and ancillary needs are addressed.

Maintains availability to members and providers to coordinate any required services.

Serve as a member advocate.

Addresses and identifies complaints, grievances, or concerns and escalates to the appropriate stakeholder(s), when necessary.

Identifies availability of advanced directives, needs for ancillary services, specialty services and community services.

Upon member ineligibility or other circumstance in which disenrollment from the program becomes necessary, complete all needed activities to ensure continuation of care and communicate with all stakeholders to ensure an uninterrupted transition of care.

Serve as a mandated reporter.

Will have access and manage PHI in accordance with federal and state requirements (HIPAA, HITECH).

Supervisory Responsibilities LPN oversight Competencies: Strong organizational, interpersonal and motivational skills Excellent written and verbal communication skills Detail oriented High level of reasoning and analytical skills Ability to multi-task and work independently Qualifications: A Minimum of three (3) years of recent adult clinical is required.

A bachelors degree in nursing is strongly preferred.

Previous work experience with a Medicare program is preferred.

Bilingual (Spanish) is preferred.

Certificates, Licenses, Registrations: Certified Case Management (CCM) Certification is preferred.

Current RN licensure in states where business is conducted.

Computer Skills: Demonstrated computer proficiency with Microsoft Office, electronic health record (EHR/EMR) systems, Medicaid documentation and care management platforms, and the ability to efficiently navigate multiple electronic systems while maintaining accurate, timely, and compliant clinical documentation in accordance with state and regulatory requirements.

Environmental Factors/Physical Demands Work is performed in an office environment.

While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data int...