Position Summary
The Population Health Care Manager RN will be responsible for coordinating and facilitating comprehensive care for chronic conditions, medical complexities, mental health, and those with psychosocial issues through provider education and collaboration.
The role involves working across healthcare providers to advocate for members and educate providers, ensure effective communication, and monitor member progress to promote positive outcomes and improve overall well-being.
This role is ideal for someone with strong clinical and case management skills, a passion for chronic disease management, and the ability to engage with diverse populations and healthcare teams to improve member outcomes.
This is a telework role, based out of Maricopa County, AZ, that will require 10-25% travel to provider locations. Working schedule: Monday - Friday, 8am-5pm Arizona Time, with a flexible schedule potentially available after orientation and training period.
Key Responsibilities
- Develop and implement pilot programs for population health initiatives, as determined by health plan priorities.
- Analyze member data (medical history, test results, treatment plans) to understand their health status. May be required to present data to health plan leadership.
- Create educational resources and presentations about chronic conditions and condition management initiatives.
- Assess member needs, identify personalized plans, and coordinate services across healthcare providers.
- Advocate for members to ensure they receive accurate and appropriate resources and care.
- Utilize various communication platforms (secure messages, video calls, files) for care coordination and collaboration.
- Assist providers with managing members with chronic conditions; this may include conducting outreach and follow-ups through multiple channels.
- Participate in community-based initiatives related to care management.
- Educate members and providers on managing conditions, symptom recognition, adhering to treatment plans, and establishing self-management goals with members using motivational interviewing techniques.
- Develop resources to help members and providers optimize healthcare using community resources.
- Identify areas for improvement in processes and documentation, developing plans for action.
- May be required to perform care management with members, which includes development of personalized care plans and monitoring progress, facilitating communication between healthcare providers, members, families, and completing documentation processes as part of the Integrated Care Management department.
- Perform other duties as assigned.
Required Qualifications
- Resides in Maricopa County, Arizona.
- Active and unrestricted AZ state RN (Registered Nurse) licensure.
- 5+ years' experience as an RN.
- 1+ year of experience with speaking with members in-person, over the phone, or virtually, as well as creating and delivering presentations to diverse groups and individuals.
- Willingness to travel within Maricopa County 10%-25% of the time to provider locations
Preferred Qualifications
- Managed care experience.
- Case/care management experience.
- Excellent problem-solving and decision-making.
- Medical terminology knowledge.
- Strong digital literacy and communication tools.
- Ability to work with diverse groups and handle sensitive information.
- Strong organizational, prioritization, and flexibility skills.
- Customer relations and critical thinking skills.
- Attention to detail and ability to analyze and plan effectively.
- Bachelor's degree.
Education
- Associate's degree in Nursing.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is
$60,522.00 - $129,615.00