• Job Description

  Req#: 26-03750
  
  Job Profile Summary:
  
  Position Purpose:
  Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.
  
  Education/Experience:
  Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 – 4 years of related experience.
  
  License/Certification:
  RN - Registered Nurse - State Licensure and/or Compact State Licensure required
  
  For YouthCare Illinois plan only: Bachelor’s Degree and IL RN licensure required. Must reside in IL
  
  For Sunshine Health (FL) Only: Employees supporting Florida's Children’s Medical Services (CMS) must have a minimum of two years of pediatric experience. May require up to 80% local travel required
  
  Responsibilities:
  Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome
  
  Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs
  
  Identifies problems/barriers to care and provide appropriate care management interventions
  
  Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services
  
  Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs
  
  Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate
  
  Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services
  
  May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
  
  Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
  
  Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits
  
  Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner
  
  Other duties or responsibilities as assigned by people leader to meet business needs Performs other duties as assigned.
  
  Complies with all policies and standards.
  
  EEO:
  
  “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
  
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  Story Behind the Need
  What is the purpose of this team? Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?	The purpose of this team is to provide comprehensive case management services to MyCare waiver members living in the community. The team ensures members receive the appropriate level of support, care coordination, and advocacy needed to maintain safety, independence, and quality of life across medical, behavioral, and social domains. Managing increasing MyCare waiver membership and ensuring timely outreach and assessments Improving quality metrics through proactive care coordination and care plan adherence Enhancing member engagement, especially among hard ‐ to ‐ reach or high ‐ risk individuals Supporting transitions of care, such as hospital discharges, skilled nursing placements, or changes in service needs Partnering with providers and community agencies to close gaps in care, address social determinants, and secure needed supports
  Typical Day in the Role
  Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?	Conducting outreach, assessments, and care planning for MyCare waiver members, ensuring care is coordinated across medical, behavioral, and LTSS needs. Coordinating services and collaborating with providers, waiver service coordinators, and interdisciplinary partners to ensure continuity of care, including transitions between levels of care. Monitoring member needs, evaluating progress toward care plan goals, and adjusting services as new needs arise. Participating in care conferences and reviewing cases that require elevated attention or troubleshooting—especially those impacted by staffing transitions or complex care needs. Documenting all activities thoroughly in TruCare/other care management systems to ensure accuracy, compliance, and proper communication across teams. Collaborating with internal partners (AAA, authorization teams, supervisors) when member issues escalate or require multidisciplinary problem-solving
  Candidate Requirements
  Education/Certification	Required: Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4–6 years of related experience	Preferred: Bachelor's degree in Nursing preferred
  Licensure	Required: RN Licensure in OH	Preferred:
  Years of experience required: 2-4 year in home care, case management or equivalent, behavioral health. reliable vehicle for weekly travel Disqualifiers: Inability to work independently, manage change well, position longevity (state if contract role), Additional qualities to look for: Someone who works well independently, personable, strong communication skills. Someone who can think critically, be flexible, open to change, and can also work well on a team.
  Top 3 must-have hard skills stack-ranked by importance	1	Communication skills, Critical thinker, problem solver.
  2	Computer Basic Technical Skills A MUST knowledge of Microsoft Excel, Word, Team, Outlook, One note, One Drive, Powerpoint, Explorer, Chrome,
  3	Works well independently, troubleshooting
  Candidate Review & Selection
  Shortlisting process Candidate review & selection Interview information Onboard process and expectations	Projected Manager Candidate Review Date:	24-48 hours of qual
  Type of Interviews:	Teams - Camera On
  Required Testing or Assessment (by Vendor):	Agencies must perform computer literacy test - Excel, Word, Team, Outlook, One note, One Drive, Powerpoint, Explorer, Chrome
  Next Steps
  Do you have any upcoming PTO?	No
  
  

• About the company

  Mindlance is one of the largest diversity-owned staffing firms in the US . As a recruitment centric talent acquisition company, Mindlance provides Technology, Engineering, Digital / Creative / Marketing, Clinical Research, Scientific, Finance, Professional and Payroll Management staffing services to Global 1000 companies across the US, Canada and India.

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