Care Manager, (RN) Child & Adolescent Services - Denver Based

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OVERVIEW OF POSITION

The Care Manager (RN) is responsible for delivering clinically and psychosocially informed, person-centered care management services to Medicaid members with complex physical, behavioral health, and social determinants of health.

This role conducts comprehensive clinical and/or biopsychosocial assessments, manages Transitions of Care (TOC) and other high-risk outreach, develops individualized care plans, and supports members through care coordination, system navigation, and condition management.

The Care Manager is a licensed professional who collaborates with interdisciplinary and multi-agency teams to ensure coordinated, high-quality care that improves member engagement, stability, health outcomes, and reduces avoidable utilization.

This role requires comfort with outbound outreach, including cold-call engagement of hard-to-reach members, to meet program productivity standards and contractual performance requirements.

This person must be located in the Denver area

POPULATION SERVED

- Medicaid and designated high-risk, complex member populations
- Member requiring transition-of-care support
- Member with repeated utilization, worsening acuity, or chronic-condition instability
- Member with psychosocial, behavioral health, environmental, or social determinants of health barriers
- Member requiring community-resource linkage and psychosocial intervention
- Other assigned populations as applicable

EDUCATION

Active unrestricted Registered Nurse (RN) license in good standing.

Must be licensed in the state where the assigned population is served.

EXPERIENCE

1+ years of experience in care management, care coordination, case management, behavioral health, social work, utilization management, transitional care, or related experience.

Experience working with high-risk, medically complex, behavioral health, or psychosocially complex populations.

Experience supporting transitions of care.

Salary Range

Salary Range: $63,502.40- $90,719.20

Additional Compensation: Eligible for annual bonus based on individual and/or company performance.

Benefits: Includes medical, dental, and vision insurance; 401(k); paid time off (PTO); and Employee Assistance Program (EAP)

Application Deadline: Open until filled. Applications will be reviewed on a rolling basis.

How to Apply: Apply via careers page at https://alpinephysicians.wd1.myworkdayjobs.com/external

Responsibilities

Perform comprehensive clinical and/or psychosocial assessments for assigned high-risk, medically complex, and high-barrier members .; Develop, implement, and update individualized care plans addressing medical, behavioral health, psychosocial, and environmental needs.; Manage transitions of care following hospitalization, emergency department utilization, facility stays, behavioral health transitions, or other acute episodes.; Complete all required follow-up for transition-of-care and assigned populations within established timelines.; Conduct ongoing care management, monitoring, and coordination for designated members .; Identify and address barriers affecting adherence, recovery, stabilization, and follow-up, including housing, transportation, food insecurity, caregiver support, financial strain, behavioral health, and substance use concerns.; Coordinate care with PCPs, specialists, behavioral health providers, facilities, caregivers, interdisciplinary teams, and community agencies.; Connect patients to community resources, social services, behavioral health resources, and support programs.; Provide patient and caregiver education related to disease management, self-management, care navigation, resource access, and next steps in care.; Utilize motivational interviewing, engagement strategies, and de-escalation techniques to support member participation and goal attainment.; Escalate urgent clinical, psychosocial, crisis, safety, or member-protection concerns appropriately.; Collaborate with interdisciplinary teams to support integrated, person-centered care delivery.; Maintain timely, accurate, and compliant documentation across assessments, care plans, outreach, follow-up, and coordination activities.; Maintains a high level of confidentiality and ensures compliance with HIPAA regulations; Assist with planning, coordinating, and representing the organization at community events designed to retain existing members and generate awareness among prospective members.; Deliver educational presentations to existing and prospective members at community events, clinics, and partner sites: evening and weekend availability is required to support scheduled events and community programming.; Other duties as assigned

Requirements

Knowledge of community resources and behavioral health supports.; Proficiency with EMR and care-management documentation systems.; Complete assessments, care plans, outreach, and follow-up activities within required timelines.; Complete transition-of-care follow-up within organizationally defined timeframes.; Maintain timely and compliant documentation across all care management activities.; Meet expectations related to care-plan completion, case progression, barrier resolution, and member engagement.; Escalate urgent or deteriorating clinical, psychosocial, or safety concerns promptly.; Meet role-specific LPIs/productivity expectations and delegated responsibilities.; Strong clinical and/or psychosocial assessment and intervention skills; Strong care planning and coordination capability; Knowledge of behavioral health, community-resource systems, and social determinants of health; Strong crisis support and de-escalation ability; Ability to manage medically complex and high-barrier patients across settings; Strong communication and collaboration with providers, caregivers, and interdisciplinary teams; Motivational interviewing and patient engagement skills; Strong documentation, follow-through, and compliance discipline; Ability to prioritize risk and intervene appropriately; Ability to manage sensitive and complex cases professionally; Home office, that is HIPAA comp

Nice to have

Experience with Medicare Advantage, Medicaid, DSNP, and/or CSNP populations.; Experience in value-based care, managed care, or population health.; Case management certification or related credential.; Bilingual capability, where relevant to market needs