Who you are:

You are a RN (or LCSW-C) who is passionate about making sure our patients have the resources they need to heal. You love putting the many pieces of care management puzzle together, because in the end you know it affects our member's lives. You have initiative, both to seek information and in your outreach to our members. You understand the importance and value of meeting documentation requirements and you know how to close the gaps in care.

What you'll do:

• Provide support and guidance to our members
  • Quality care coordination to make sure members have access to services, while being mindful of under/over utilization
• As you are working for a payer, you'll meet the documentation requirements with a focus on HEDIS measure
• Connect members with community support
• Be a resource for our members
  • You clarify benefits (you don't administer)

What you bring:

• Personal accountability and initiative
• Excellent phone skills and experience engaging members telephonically
• Flexibility, highly adaptable to a dynamic and changing environment
• 2 years' clinical experience as a RN or LCSW-C in an acute care setting preferred
• Care management experience (from a payer perspective) is preferred
• Current state licensure (RN or LCSW-C) (or Compact licensure with the ability to practice in Maryland)
• Knowledge of Maryland managed care organizations

Who we are:

Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine. JHHC is a $2.5B business serving over 450,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins HealthCare, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHC is the place to call home.

If you reside in one of the following states, this position can be considered for virtual work: MD, VA, FL, PA, DE, or District of Columbia

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.