Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
RN Care Manager-Work At Home
Join Our Team and S.O.A.R!
S-Spark Curiosity O- One Team, One Direction A- Action for Results R- Right by Right Purpose
Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. We contact members with multiple chronic conditions as well as financial and functional barriers in order to assist them in achieving and maintaining optimum health. We provide telephonic outreach to assess and support their health, offering education, identifying resources, and helping remove barriers to achieving health and independence while using a multidisciplinary team.
This position will be part of our Special Needs Program (SNP) team. All of our SNP RN Care Managers are work-at-home associates, working from a dedicated home office space. Work-at-home care managers are responsible for meeting quality and productivity measures daily and maintaining working home internet at all times with demonstrated advanced communication and interpersonal skills.
This is a very compliance-driven and highly visible program. The nature of the work requires telephonic interaction with members during the majority of the business day, primarily through an autodialer system. The environment is fast-paced and requires the ability to engage quickly with members while concurrently navigating multiple computer applications. Due to the auto-dialer process and compliance needs of the business, there is limited day-to-day flexibility in the care manager’s schedule.
- Telephonically assess Medicare, Medicaid, and/or Group Account members and create actionable and measurable care plans to help guide and track the members' progress toward goals
- Use nursing judgment to assess and coordinate care for acute situations (APS, EMS)
- Discuss transitions of care to assist with safe discharge to the home and coordinate care for DME, home health, provider appointments, etc.
- Guide members and their families toward and facilitate interaction with resources appropriate for the care and wellbeing of members
- Assess member’s physical, environmental and psycho-social health issues and work in collaboration with a multi-disciplinary team, such as social workers, dietitians, pharmacists, etc., employing a variety of strategies/techniques to manage appropriately and provide timely intervention
Benefits of working with Sagility include
- Performance incentives
- Paid training within a state-of-art video training environment
- Employee wellness and engagement programs
- Active Registered Nurse (R.N.) license with no disciplinary action.
- Hold an active Compact nursing license and reside in the state that holds your compact license.
- The National Council of State Boards of Nursing (NCSBN) developed the Nursing Licensure Compact (NLC), which is an agreement between states that allows nurses to have one license and the ability to practice in all the states that participate in the program. License must be current with no disciplinary action.
- Minimum education of an Associates degree in Nursing.
- Seasoned RN with a minimum of 3 years of clinical nursing experience.
- Demonstrated clinical knowledge and expertise as evidenced by providing intervention to manage variety chronic conditions, including development and implementation of individualized care planning.
- Intermediate to advanced computer skills as evidenced by ability to navigate multiple systems, utilizing dual computer monitors.
- Provide autonomous decision-making, troubleshooting and problem solving related to periodic system issues.
- Experience with Microsoft and Excel
- Ability to quickly learn and navigate software programs and applications.
- Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously.
- Effective communication and interpersonal skills.
- Effective problem solving and appropriate application of clinical knowledge
- Must have a separate room with a locked door that can be used as a home-office to ensure you and your members have absolute and continuous privacy while you work.
- Must possess advanced telephonic and virtual communication skills.
- BSN or MSN degree in nursing or equivalent
- Previous adult chronic conditions care management
- Previous experience in care management including knowledge of complex care management and care management principles
- Experience with motivational interviewing
- Experience with MCG or CMS guidelines, assessment and documentation practice
- Individual licenses in non-compact states
- Hardwired internet connection with a minimum download speed of 25 Mbps and an upload speed of 10 Mbps
- Secure, private dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Work@Home USAUnited States of America