Healthy First Steps RN Case Manager - East TN Region

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The Healthy First Steps and NICU (HSS) Clinical Coordinator RN role provides comprehensive care management for a high risk specialty population, addressing medical, behavioral health, and social determinants of health needs. This role is dedicated to improving maternal and infant outcomes through proactive engagement, evidence based education, early identification of risks, and connection to appropriate clinical and community resources.

If you are located in TN, you will have the flexibility to work remotely as you take on some tough challenges

For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

• Identify medical, behavioral, and social risk factors and develop individualized plans of care to address identified needs
• Conduct outbound and inbound calls with members in the specialty population to assess current health status and determine care coordination needs
• Initiate referrals to community resources to address social determinants of health, ensure referral closure, and track outcomes
• Collaborate with Medical Directors on complex or challenging cases requiring clinical escalation
• Provide evidence-based education to support member self-management of identified health risks
• Coordinate care and connect members to appropriate services, both internally and externally
• Partner with members to establish and maintain a plan of care focused on achieving optimal health outcomes
• Manage assigned queues to ensure timely follow-up and proactive outreach to the specialty population
• Coordinate care with healthcare providers and other care team members as needed
• Document assessments, findings, interventions, and outcomes in the internal care management system according to policy requirements
• Comply with departmental policies as well as internal, external, and regulatory requirements (including legal and compliance standards)
• Educate and support non-clinical team members involved in member care coordination
• Perform other related duties as assigned to support program and organizational goals