RN Case Manager (Complex Care)

Evolent Health, Inc. Fort Myers , FL 33912

Posted 2 days ago

It's Time For A Change Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely about 40% in year-over-year revenue growth in 2018 . Are we recognized? Definitely. We have been named one of "Becker's 150 Great Places to Work in Healthcare" in 2016, 2017, 2018 and 2019, and One of the "50 Great Places to Work" in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.

What You'll Be Doing:

Evolent Health is seeking an RN Care Advisor to join the population health team. Our goal is to partner local organizations in their strategic evolution to positively impact and improve the healthcare delivery system.

Our goal is to partner local organizations in their strategic evolution to positively impact and improve the healthcare delivery system. As a member of a team of nurses, social workers, registered dieticians, physicians, pharmacists, and program coordinators, you will have the opportunity to make a profound impact on the lives of people living with complex and/ or chronic conditions. You will connect with your patients in person, on the phone, in the hospital, and in the physician's office - essentially however and wherever the patient needs your assistance to improve their health, better understand their illness and coordinate their care. Candidates must be prepared to work from EVH office, hospital or physician office. Under the supervision of the Manager of Care Coordination, the Care Advisor identifies, assesses, plans, coordinates and implements appropriate cost-effective healthcare services for individuals identified with special health care needs. Special health care needs are defined as members who have or are at increased risk for chronic, physical, developmental, behavioral, or emotional conditions and who require health and related services of a type or amount beyond that required by members generally. The goal of the case manager is to provide an optimal outcome for the client though collaborating with the client, physician, family and other members of the health care team.

Responsibilities:

  • This RN Care Advisor will connect with the patients in person (through home visits), on the phone (in the EVH office), embedded (on site) in the physician offices. The RN CA will be providing face to-face interaction with patients and their care team when appropriate to improve patient care.

  • Along with other members of the Population Health team, conduct comprehensive assessments that include the medical, behavioral, pharmaceutical and social needs of the patient, identify gaps in care and barriers to attaining improved health.

  • Based on this assessment, and in conjunction with the patient, the patient's physician and other members of the population health team, create and implement a care plan that will address the identified needs, remove the barriers and improve the health of the patient.

  • Coordinate care by serving as the contact point, advocate and resource for the patient, their family and their physician, building effective relationships through trust, respect and communication.

  • In close collaboration with the patient, primary care provider and care team you will continually assesses the patient's knowledge of their clinical condition(s) and provide education and self-management support based on the patient's unique learning style.

  • Measure, improve and maintain quality outcomes (clinical, financial, and functional) for individual patients and the population served.

  • Maintains a current knowledge base with regards to rules, regulations, policies, and procedures relating to Medical Management. Regularly reviews and monitors compliance with the Health Plan's policies and procedures.

  • Adheres to DMS, state, and federal regulations.

  • Promptly makes recommendations to ensure compliance with rules, regulations, policies, and procedures.

  • Assists with developing and updating policies and procedures, as needed or requested.

  • Serves as a resource for internal and external customers regarding appropriate and alternative delivery settings, systems, and interventions.

  • Participates with outside agencies and community groups, as requested, with regards to program goals and improved member health outcomes.

The Experience You Need (Required):

  • Associates Degree in Nursing

  • 3-5 years of nursing experience, preferably in home health, ambulatory care, community public health, case management, coordinating care across multiple settings and with multiple providers

  • Current FL Registered Nurse license

  • CCMC (Commission for Case Manager Certification) or ability to sit for the exam, within 24 months of employment.

  • Unrestricted license to practice nursing in the state of FL

Finishing Touches (Preferred):

  • Bachelor's Degree in Nursing preferred

  • Fluency in Spanish and English

  • Experience with pediatrics, children with special needs, behavioral health and maternity populations

  • Knowledge and experience teaching self-management.

  • Experience with electronic health records

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, or national origin.


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RN Case Manager (Complex Care)

Evolent Health, Inc.