What are the responsibilities and job description for the Registered Nurse Care Manager position at Mercy Care?
Company Description Mercy Care is a not-for-profit health plan serving AHCCCS members across Arizona, with a long-standing commitment to Medicaid populations since 1985. Owned by Aetna/ CVS, Mercy Care connects families, children, older adults, and people with physical and developmental disabilities to comprehensive health care services. The organization also functions as the Regional Behavioral Health Authority (RBHA) in Maricopa County, providing integrated physical and behavioral health services for individuals with serious mental illness. Mercy Care manages the public behavioral health system in Arizona, offering coordinated care that supports whole-person health. Prospective team members can learn more about Mercy Care’s mission and services at www.MercyCareAZ.org.
Role Description The Registered Nurse Care Manager is a full-time remote role responsible for coordinating and managing care for Department of Child Safety Children's Health Plan members with diverse and often complex health needs. This role includes conducting telephonic or virtual health assessments, developing individualized care plans, and collaborating with interdisciplinary teams to ensure appropriate medical, behavioral, and social services are in place. The Pediatric RN Care Manager monitors member progress, provides clinical education and health coaching, and supports transitions of care across inpatient, outpatient, and community settings. Daily activities also involve reviewing clinical documentation, advocating for evidence-based treatments, and promoting adherence to care plans and preventive care guidelines. The position requires consistent communication with members, caregivers, providers, and community partners to improve health outcomes and member experience.
Qualifications
Role Description The Registered Nurse Care Manager is a full-time remote role responsible for coordinating and managing care for Department of Child Safety Children's Health Plan members with diverse and often complex health needs. This role includes conducting telephonic or virtual health assessments, developing individualized care plans, and collaborating with interdisciplinary teams to ensure appropriate medical, behavioral, and social services are in place. The Pediatric RN Care Manager monitors member progress, provides clinical education and health coaching, and supports transitions of care across inpatient, outpatient, and community settings. Daily activities also involve reviewing clinical documentation, advocating for evidence-based treatments, and promoting adherence to care plans and preventive care guidelines. The position requires consistent communication with members, caregivers, providers, and community partners to improve health outcomes and member experience.
Qualifications
- Strong clinical foundation with skills in Pediatric Nursing and Medicine to assess, plan, implement, and evaluate member-centered care.
- Experience in Nursing Management, including coordination of services, prioritization of caseloads, and collaboration within interdisciplinary teams.
- Knowledge of Critical Care Medicine principles to support members with complex and high-risk conditions.
- Demonstrated excellence in Patient Care, with a focus on safety, quality, and culturally responsive, trauma-informed practices.
- Current, unrestricted Registered Nurse (RN) license in the state of Arizona (or ability to obtain, as required).
- Experience in care management, case management, or utilization management within Medicaid or managed care settings preferred.
- Proficiency with electronic health records, care management platforms, and standard office software.
- Effective communication, critical thinking, and problem-solving skills, with the ability to work independently in a remote environment.
- Associate or Bachelor’s degree in Nursing; BSN preferred.
- Familiarity with behavioral health, community resources, and social determinants of health is highly beneficial.