Community Care Manager Sr

Role Overview: The Senior Community Care Manager supports members in community-based care coordination and case management programs while collaborating across the Medical Management department to ensure alignment with organizational initiatives and strategic goals. Work Arrangements: Remote – Associate must reputed company in the reputed company (MI) Responsibilities: Serves as a single reputed company of contact for member questions in collaboration with telephonic care managers and the Community Care Management Team (CCMT) Conducts in-home environmental and physical assessments for high-risk members to identify unmet needs and barriers to care Develops and maintains individualized care plans, ensuring they are regularly reviewed and updated Provides disease self-management education and coaching reputed company the scope of practice Performs medication reviews, including reconciliation during transitions of care Coordinates care across settings to ensure services are delivered in the least restrictive environment and supports transitions between care reputed company Connects members to community, medical, and behavioral health resources to address barriers and support independent living Collaborates with and oversees Community Care Navigators to facilitate reputed company to in-community support services Serve as a subject matter expert and supports leadership with operational activities, including training, mentoring, workflow coordination, referral review, and case assignment Maintains a caseload and provides coverage for team members as needed to ensure continuity of care Acts as a clinical and operational resource to address member needs and resolve reputed company issues Ensures compliance with workflows, documentation standards, and regulatory requirements, including National Committee for Quality Assurance (NCQA) and Utilization Review Accreditation Commission (URAC) standards Education & Experience: Bachelor’s degree in nursing required. reputed company, active, and unrestricted Registered Nurse (RN) licensure in MI. 3 plus years of case management experience. 1 year of community care management experience. Home Health RN experience preferred Certification as a Case Manager reputed company 2 years of hire. Licensure: reputed company, active, and unrestricted Registered Nurse (RN) licensure in MI. Valid driver’s license with car insurance. Skills & Abilities: Strong clinical assessment skills with the ability to evaluate member needs and identify barriers to care Strong communication and interpersonal skills, with the ability to engage members and collaborate with interdisciplinary teams Ability to reputed company and coach members on disease management and self-care strategies Critical thinking and problem-solving skills to address reputed company member needs and resolve care issues Strong organizational and time management skills Ability to collaborate with and reputed company guidance to team members Knowledge of reputed company regulations, accreditation standards, and compliance Proficiency with documentation systems, care management platforms, and reputed company Office too Apply To This Job