Nurse Case Manager
Posted on 2/25/2023

51-200 employees

Small business employee benefits platform
Company Overview
Sana's mission is to make quality healthcare understandable, accessible and affordable for all. Sana helps small businesses offer high-quality benefits, save on healthcare costs, and avoid expensive employee turnover.
Experience Level
Desired Skills
Medical, Clinical & Veterinary
  • Bachelor's degree in health related field with at least 3 years of clinical experience. Case management experience preferred
  • Active and unencumbered licensure as a Registered Nurse in Texas. Compact license preferred. Eligibility for licensure in any US state
  • Experienced in remote work
  • Excellent clinical, organizational and communication skills
  • Entrepreneurial. Self-directed. Excited to build something from scratch
  • Values-oriented. You care about making our healthcare system work better for people and business owners
  • Gritty. You aren't worried about getting your hands dirty and working hard when you need to
  • Comfortable with change. We are a startup and need people who are ok doing things outside of their traditional job description
  • Comfortable with modern web applications. We are building all of our software in-house and you will be a key constituent in its development
  • Collaborate cross-functionally with Underwriting and Claims Operations to offer a clinical perspective on certain high cost claimants. Comment end
  • Perform care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating patient-centric care plans designed to optimize member health care across the care continuum
  • Engage with members (outbound calls and emails) to assess their health status and facilitate care coordination needs
  • Identify appropriate interventions and resources to meet gaps (e.g., psychosocial, transportation, long-term care) based on specific consumer needs considering both the health care and psychosocial / socioeconomic dimensions of care
  • Collaborate with primary providers or multidisciplinary teams to align or integrate goals with the case management care plan and drive consistent coordination
  • Provide patient education on disease processes to assist with self-management
  • Be a master of member plan benefits to drive referrals to high quality, low cost care partners
  • Monitor and evaluate effectiveness of the care management plan and adjust as necessary utilizing clinical knowledge and evidence-based guidelines
  • Make 'welcome home' calls to ensure that discharged members receive the necessary services and resources
  • Assist in problem solving with providers, claims, or service issues