[Remote] Clinical Guide: Case Manager (Gold Care) at Devoted Health

United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Health InsuranceIndustries

Requirements

An unrestricted compact RN license
A minimum of 4 years of RN Case Management experience
Prior case management experience within an interdisciplinary team
Comfort with participating in interdisciplinary discussions

Responsibilities

Develop trusting long-term patient relationships that truly transform patients’ lives and empower you to do the best work of your career supported by technology and data tools
Conducting holistic assessments to identify comorbid conditions, functional status, ED/hospitalization history, medications, psychosocial factors, and member values and preferences
Developing care plans in partnership with the interdisciplinary team, members and their caregivers, with a focus on the members priorities - problems, goals, interventions - while continuously evaluating the member’s progress
Ensuring smooth transitions of care for patients in the hospital or recently discharged, seeking to minimize readmissions working with complex DME & Home Health needs
Supporting chronic disease management, using motivational interviewing and teach back method techniques, which includes coaching, remote monitoring, educating members on their chronic conditions in plain language including teaching “red flags,” developing plans during an exacerbation, and identifying barriers to important care elements
Execution and Oversight of SNP ICPs for members enrolled in Complex Care
Oversight of care coordinators in certain aspects of the care model

Skills

RN license

Case Management

Interdisciplinary Team

Holistic Assessments

Care Planning

Medicare Advantage

Transitions of Care

Patient Assessment

Devoted Health

Medicare Advantage plans with personalized support

About Devoted Health

Devoted Health provides Medicare Advantage plans aimed at simplifying and making healthcare more affordable for seniors aged 65 and older. Their plans include services like provider and pharmacy searches, prescription drug coverage, and preventive care rewards. Members pay premiums for these plans, and the company may also receive government payments for managing Medicare benefits. What sets Devoted Health apart from competitors is their high level of customer service, featuring Devoted Health Guides who assist members in navigating their healthcare options and addressing common issues with traditional insurance. Additionally, they promote preventive care through the Devoted Dollars program, which rewards members for engaging in health activities. The goal of Devoted Health is to create a more compassionate and accessible healthcare experience for its members.

Waltham, MassachusettsHeadquarters

2017Year Founded

$2,194.5MTotal Funding

SERIES_ECompany Stage

HealthcareIndustries

1,001-5,000Employees

Benefits

Comprehensive health plan

401(k) retirement plan

Generous vacation and holiday time

Lyra mental health resources

Time off to vote

Risks

Increased competition from Medicare Advantage providers like Clover Health and Oscar Health.

Potential regulatory changes affecting Medicare Advantage plans by CMS.

Rising healthcare costs could impact the affordability of Devoted Health's plans.

Differentiation

Devoted Health offers personalized assistance through Devoted Health Guides for member support.

The company emphasizes preventive care with its Devoted Dollars rewards program.

Devoted Health integrates virtual and in-home care with top local providers.

Upsides

Devoted Health raised $287 million in Series E funding in 2024.

The company expanded Medicare Advantage plans to eight new states in 2023.

Devoted Health achieved a 5-star Medicare Advantage rating in Ohio in 2023.

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