RN Care Manager (ACO Reach)

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.

The Role

As a Registered Nurse (RN) Care Manager for Belong Health's ACO program, you will be responsible for applying care management principles when engaging beneficiaries, providers, to coordinate beneficiary care including developing and maintaining a collaborative relationship with provider practices, community-based resources, and the Belong Health team.

Responsibilities

• Work directly with beneficiaries, their families and/or advocates, providers, and community service organizations on an ongoing basis to coordinate care and reduce barriers to care.
• Orient new members to the Belong Health ACO program and educate the beneficiary and/or caregivers to care management services.
• Advocate, empower, inform, and educate beneficiaries on self-management techniques.
• Conduct assessments to identify barriers and opportunities for intervention.
• Develop and implement the individual care plan (ICP).
• Lead interdisciplinary care team meetings.
• Collaborate with provider, social workers, discharge planners, and community-based service providers to coordinate care and achieve care plan goals.
• Document all care management activities in the appropriate system in accordance with internal and established documentation procedures.
• Review electronic health records to gather information about beneficiary medical, behavioral health, and social conditions.
• Promote a culture of accountability and performance to both meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex, specialized, and non-routine customer issues.
• Additional duties as assigned.
  
  

Requirements

• Active, unrestricted compact nursing license is required.
• 2+ years' experience in a health plan, health care organization (i.e. hospital or clinic), Accountable Care Organization (ACO).
• Proficient in navigating multiple systems.
• Experience in participating in cross departmental projects and policy and procedure changes, including coordination of activities and initiatives across departments.
• Excellent customer service, problem solving, trend identification, and analytical skills, with a demonstrated ability to problem solve effectively and efficiently.
• Commitment to high ethical standards in all work; protects the privacy of member and company data and exercises discretion in handling confidential member information.
• Excellent oral and written communication skills, including presentation skills.
• Strong demonstrated PC skills using Microsoft applications.
• Strong active listening, issue assessment and problem-solving skills.
• Strong organizational and follow-through skills.
• Knowledge of community services and resources (preferred).
• Previous care management experience (preferred).
• Bi-lingual Spanish speaking (preferred).
• Must be willing to travel to Philadelphia for quarterly onsite trainings.
  
  

Salary Range

• $90,000-$105,000
  
  

Physical Demands

These demands must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to sit, talk, or hear. There are no special vision requirements.
• Some travel to corporate locations, customer sites, and trade shows may be required to fulfill the position's requirements.
  
  

Work Environment

The work environment characteristics described here are representative of those encountered while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions

• The noise level in the work environment is usually quiet
  
  

Health & Safety

Belong Health and its partners require full vaccination for associates and select contractors who conduct work outside of their home on behalf of Belong Health and its partners. This applies to those who work within our facilities; interact directly with members and patients; attend in-person meetings or trainings; and/or represent Belong Health at events or volunteer activities. Medical and religious exemptions will be considered, and this policy will not supersede state or local laws.

Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.

Our organization participates in E-Verify to confirm the eligibility of employees to work in the United States. (Nuestra organización participa en E-Verify para confirmar la elegibilidad de los empleados para trabajar en los Estados Unidos.)