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Bilingual RN Case Manager, Transitions of Care
Devoted Health. Provide telephonic, short-term, interdisciplinary care management in the 30 days post-discharge for patients at high risk for readmission .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in telephonic care management, patient advocacy, and interdisciplinary collaboration to ensure effective post-discharge support. Proficient in developing care plans and educating patients on chronic conditions while utilizing clinical analytical thinking to address individual patient needs.
Highest-signal resume keywords
RN LicenseTelephonic Care ManagementBilingual English/SpanishMedicare Advantage ExperienceClinical Analytical Thinking
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care ManagementPatient AdvocacyCare Plan DevelopmentPatient EducationAssessment of Comorbid ConditionsMedication AdherenceData Tools UtilizationEvidence-Based HealthcareCare Gap ManagementTransitions of Care
Soft Skills
CommunicationInterpersonal SkillsEmpathyProblem-SolvingEnthusiasm for Patient Interaction
Certifications & Qualifications
Unrestricted Compact RN License
Industry Keywords
Health InsuranceMedicare AdvantageSpecial Needs PlanPopulation HealthPost-Discharge Care
About the role
Key responsibilities & impact- Provide telephonic, short-term, interdisciplinary care management in the 30 days post-discharge for patients at high risk for readmission
- Advocate for patients by coordinating care and ensuring necessary resources and support
- Engage newly discharged patients telephonically to understand their needs using technology and data tools
- Conduct assessments covering comorbid conditions, ED/hospitalization history, medications, psychosocial factors, and patient values and preferences
- Develop care plans with patients and caregivers, including problems, goals, and interventions, while evaluating progress
- Explain complicated medical terms in plain language
- Educate patients on chronic conditions, red flags, exacerbation plans, and barriers such as medication adherence
- Provide active care management to close care gaps
- Partner with TOC Nurse Practitioners and Physicians on handoffs, follow-up, and coordinated post-discharge care
- Refer patients to Devoted Medical when applicable
- Work with Devoted Community Guides to identify community-based organizations
- Coordinate post-treatment care and DME needs
- Collaborate with PCP partners to deliver evidence-based, effective, and accessible healthcare
Requirements
What you’ll need- An unrestricted Compact RN license obtained in the United States with the ability to secure other licensure states
- 3-4 Years of Experience of RN Care Management/telephonic case management experience
- Fully bilingual in English/Spanish
- Located in CT/MT/PT time zones
- Enthusiasm for working in a setting where meaningful time is spent on the phone with patients and/or their caregivers
- Comfort and confidence working in an environment guided by performance and productivity metrics, with a focus on quality outcomes and patient experience
- Health insurance experience, particularly Medicare Advantage
- Prior Special Needs Plan, Population Health, or Transitions of Care case/care management experience
- Clinical analytical thinking that allows you to apply your skills to the individual needs of each patient
- Telephonic care/case management experience
Benefits
Comp & perks- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Bonus eligibility for all roles excluding Director and above
- Parental leave program
- 401K program