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Oak HC/FT

Nurse Care Manager - Philadelphia

Quartet Health

Quartet Health

Customer Service
Philadelphia, PA, USA
Posted on Tuesday, August 15, 2023

About Quartet Health

Quartet is a purpose driven value-based behavioral healthcare company, building the nation’s leading behavioral health home. We deliver integrated care and better outcomes to improve the health of communities across America. Quartet is a trusted partner of health insurance plans, health systems, community behavioral health centers, certified community behavioral health clinics, and federally qualified health centers in 36 states across the country. We identify people in need of care and connect them directly to high quality behavioral care providers, including Quartet’s own medical group.

At Quartet, our values guide the way that we work together, starting with our commitment to putting patients first, and our shared focus on collaboration and innovation, so that we – together – can improve lives, one person at a time.

Quartet is backed by top investors like Oak HC/FT, GV (formerly Google Ventures), F-Prime Capital Partners, Polaris Partners, Deerfield Management, Centene Corporation, Independence Health Group, and Echo Health Ventures.

Our Benefits

​We're proud to offer the following benefits to all clinicians:

  • Competitive compensation​
  • 100% cost coverage for a​ll required licensing​/credentialing fees
  • ​IT equipment and ​support
  • Mental health benefits via our EAP, with up to 5 free counseling sessions per concern

​W​e offer additional benefits to our team members working full time:

  • ​​A​ generous accrued PTO policy in addition to paid holidays and paid maternity leave
  • ​R​obust medical, dental and vision insurance plans
  • A 401​(k​) plan with employer match
  • 100% employer-paid life insurance​, short-term and long-term disability insurance
  • ​Annual continuing education​ unit (CEU) budge​t

About the Team & Opportunity:

Quartet is looking for a Nurse Care Manager in the Philadelphia area who is passionate about providing holistic care to those with serious mental illness. Our Nurse Care Manager is a critical member of our multidisciplinary team, responsible for managing behavioral care for adult patients with serious mental illness, both virtually and in person.

The Nurse Care Manager works to assess, evaluate, and support members who are challenged by both severe mental illness and complex needs. The Nurse Care Manager follows established guidelines and procedures and collaborates with other departments. They will work as part of a multidisciplinary team that assesses, facilitates, plans, and coordinates an integrated delivery of care across the continuum. The goal of the Nurse Care Manager is to support members to achieve or maintain optimal health in both mind and body.

The Nurse Care Manager employs their clinical judgment with individualized strategies to manage a member's physical, environmental and psycho-social health issues. The Nurse Care Manager monitors members’ progress towards desired outcomes and helps to ensure the member receives quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.

By continuously monitoring patient care, the Nurse Care Manager conducts regular assessments and identifies and resolves barriers that hinder effective care. The Nurse Care Manager will create and update member care plans and participate in the Interdisciplinary Care Team as needed.

Responsibilities

  • Meet with crisis team, case managers in the hospital, and primary care for referrals and coordination of care
  • Ability to meet patients in their home environment, as needed
  • Ability to review medication lists and assess appropriateness of injectables
  • Comfortable managing patients experiencing a crisis situation
  • Familiarity with health plan and comfort interacting with Case management
  • Coordination of services that may require prior authorizations or UM review
  • Experience working with Electronic Medical Records (EMR)
  • Coordinate and monitor the overall care of SMI patients, ensuring timely access to necessary services and interventions
  • Conduct regular assessments to evaluate patients’ mental health status, identifying any changes or potential complications
  • Provide ongoing care coordination and support, including referrals to appropriate specialists and community resources
  • Educate and empower patients and their families regarding self-care, symptom management, and strategies for improving overall well-being
  • Coordinate communication and collaboration among team members, ensuring efficient and effective delivery of services
  • Advocate for SMI patients to ensure access to appropriate and timely care, including assistance with insurance, referrals, and community support
  • Monitor and evaluate the progress and outcomes of treatment plans, making adjustments as needed and ensuring ongoing support for patients’ needs
  • Willingness to assist with after hours call coverage
  • Ability to travel locally at least 60% of the time to see patients in the hospital, home and community
  • Have a valid driver’s license, active auto insurance, have access to a car and willingness to drive to the patient location

Minimum Qualifications

  • Current, unrestricted PA RN license or Compact License Preferred.
  • Experience in managing members with Behavioral Health needs and/or Substance Use needs.
  • Ability to travel locally at least 60% of the time to see patients in the hospital, home and community
  • Have a valid driver’s license, active auto insurance, have access to a car and willingness to drive to the patient location
  • Excellent written and verbal communication with an emphasis on clarity and compassion
  • Strong computer skills, including experience working with Electronic Health Records (EHR).
  • Basic understanding of insurance products, benefits, coverage limitations, laws and regulations as it applies to the health plan.

Preferred but not required Qualifications

  • Knowledge of the local health system landscape and available providers in the greater Philadelphia area
  • Experience working with academic health systems
  • Strong counseling or customer service background and can implement functional treatment plans
  • Experienced in using Microsoft Word and Excel as well as ability to work with multiple applications
  • Bilingual candidate (Spanish and/or other languages)
  • Passionate about helping build innovative models of care that improve the lives of vulnerable populations

Hiring at Quartet:

Quartet actively encourages applicants of all backgrounds to apply and is proud to be an equal opportunity employer. We do not discriminate on the basis of race, color, ancestry, religion, national origin, sexual orientation, age, citizenship, marital or family status, disability, gender, gender identity or expression, pregnancy or caregiver status, veteran status, or any other legally protected status. To perform this job successfully, an individual must be able to perform essential job duties - reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential job functions. If you require assistance in completing this application, interviewing, or otherwise participating in the employee selection process, please direct your inquiries to talent@quartethealth.com

Headhunters and recruitment agencies may not submit resumes/CVs through this Web site or directly to managers. Quartet does not accept unsolicited headhunter and agency resumes. We will not pay fees to any third-party agency or company that does not have a signed agreement with Quartet.