Company Statement
Connecticare is a leading health plan in the state of Connecticut and a subsidiary of EmblemHealth, a health and wellness company that provides insurance plans, primary and specialty care, and wellness solutions. WellSpark is a digital wellness company and national subsidiary of EmblemHealth that offers a full suite of products and solutions to reward people for healthy behaviors.
Case Manager (Registered Nurse) - Remote
Summary of Position
• Provides in person and or telephonic Case Management Services to identified high risk PHSO (Population Health Service
Organization) patients within the community including but not limited to Physician Practices and Neighborhood Care Centers.
• Consults with patients on their medications and durable medical equipment, reviewing patient care plans, addressing home
care needs, and connecting patients to community resources.
• Collaborates with primary care physicians and other providers to ensure there are no gaps in care; the goal to improve health
care outcomes and appropriate and timely utilization of services across the continuum of care.
• Collaborates with patients, providers, and caregivers to ensure positive care outcomes during care transitions.
Principal Accountabilities
• Provides patient education to assist with self-management, educate on disease processes, and encourage healthy
lifestyle changes. Includes patient and family as appropriate. Engages actively with the primary care provider (PCP)
/designee.
• Engages with the patient in support of their treatment team to identify and establish attainable goals that positively
impact clinical, financial, and quality of life outcomes.
• Assesses the needs of patients and aligns them with the appropriate member of the care team (wellness team,
registered dietitian, social worker) and develops a patient-centric care plan.
• Monitors, documents, and tracks care team performance to ensure patients are engaged in a timely fashion and
that performance metrics (Admits, ER utilization etc.) meet or exceed established thresholds.
• Provides ongoing monitoring, evaluation, support, and guidance to the coordination of the patient’s health care.
• Ensures that discharged patients receive the necessary services and resources, including medication reconciliation
and coordinating services such as home health and DME, as needed.
• Works collaboratively with medical office team members with the goal of maintaining team performance and high
morale.
Education, Training, Licenses, Certifications
• Current, unencumbered New York State Registered Nurse license (R)
• CCM (Case Management) certification (P)
• Bachelor’s degree (P)
Relevant Work Experience, Knowledge, Skills, and Abilities
• Minimum 4 - 6 years’ RN clinical experience. (R)
• Excellent verbal and written communication skills, including phone etiquette. (R)
• Strong working knowledge of Microsoft Office applications including proficiency in MS Word and Excel (R)
• Proficiency in the use of EMR (Electronic Medical Record) systems
• Ability to effectively manage a team of highly complex patients (R)
• Ability to support an integrated care model tapping into appropriate resources both internally and external to the
organization. (R)
Security Disclosure
If you are offered a job from one of the EmblemHealth family of companies that includes ConnectiCare, AdvantageCare Physicians, and WellSpark, the offer confirmation email will come from “HRTalentAcquisition” with the subject line: “Offer of Employment for (job title)” – Please respond online”.
We never ask you to join a Google Hangout, request you to purchase your own equipment or pay to apply. We do not send email from a third-party email service such as Yahoo or Gmail.
Pay Disclosure
A good faith estimate of the compensation range for individuals hired to work for the EmblemHealth Family of Companies is provided. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate’s work experience, education/training, internal peer equity, and market and business considerations. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. It is not typical for an individual to be hired at or near the top of the range, as compensation decisions depend on each case’s facts and circumstances. Union roles covered by a collective bargaining agreement will compensate in accordance with the union contract.
EEOC Statement
We are committed to leveraging the diverse backgrounds, perspectives, and experiences of our workforce to create opportunities for our people and our business. We are an equal opportunity/affirmative action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy or related condition, marital status, national origin, disability, protected veteran status or any other characteristic protected by law.