Care Navigation Nurse

Hi, we’re Gravie. Our mission is to create health benefits that actually benefit small and midsize businesses and their employees. Our innovative benefit solutions and services are developed and delivered by a diverse group of unique people. We encourage you to be your authentic self - we like you that way.

A Little More About The role:

We are seeking an experienced Care Navigation RN to provide direct, patient-centered support to our members. In this role, you will be the primary point of contact for members navigating complex health journeys. You will utilize your clinical expertise to improve health outcomes, reduce barriers to care, reduce costs, and provide compassionate advocacy within a high-performance, virtual environment.

You will:

⦁ Deliver coordinated, patient-centered virtual Care Navigation by telephone and digital channels to improve member health outcomes and satisfaction.

⦁ Lead proactive outreach efforts to identify high-risk individuals; complete comprehensive clinical assessments and develop tailored care plans for enrolled members.

⦁ Utilize the Nursing Process and a holistic "whole person" approach—including pharmacy interventions, crisis support, and disease-specific education—to support members.

⦁ Assist members in navigating the complexities of the healthcare system, providing education and empowerment to help them meet their healthcare goals.

⦁ Provide longitudinal Care Navigation during acute episodes, such as hospitalizations and rehabilitation stays, supporting both the member and their family through the transition of care.

⦁ Identify clinical or social barriers to health and provide targeted interventions, connecting members to relevant health benefit resources and social determinants of health (SDOH) support.

⦁ Work alongside other stakeholders and partners on co-managed cases and collaborate with internal teams to resolve complex benefit and claims questions.

⦁ Build supportive, trusting relationships through passionate follow-up care and consistent advocacy.

⦁ Maintain strict compliance with all regulatory, accreditation, and internal policy standards.

⦁ Demonstrate an understanding of the functions of other departments, communicate with other departments appropriately and maintain positive working relationships.

You bring: 

⦁ Active RN license in a compact state with the ability to obtain licensure in other states as needed.

⦁ 2+ years of experience in case management for a health plan or TPA and 2+ years of experience in a hospital or clinical setting.

⦁ Experience across multiple specialties, including med/surg, oncology, behavioral health, maternity, critical care/emergency, pediatrics, or community care.

⦁ Strong competence in using multiple computer/medical record systems (EMRs), preferably Salesforce, and Google Workspace.

⦁ Ability to talk, type, and navigate an electronic chart simultaneously in a remote setting.

⦁ Proven ability to prioritize assignments, manage a busy caseload, and meet daily goals independently.

⦁ Experience in telephonic care management with no direct/face-to-face patient contact.

⦁ A drive for identifying and implementing clinical best practices.

Extra credit: 

⦁ Knowledge of Managed Care Programs

⦁ Knowledge or certification in Motivational Interviewing

⦁ Case Manager Certification

Gravie: 

 In order to create a more equitable and sustainable future for employer-sponsored health insurance, we need talented people doing amazing work. In exchange, we offer a great overall employee experience with opportunities for career growth, meaningful mission-driven work, and an above average total rewards package.

 The salary range for this position is $71,400 - $118,00 annually. Numerous factors including, but not limited to, education, skills, work experience, certifications, etc. will be considered when determining compensation.  

 Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation package apart. In addition to standard health and wellness benefits, Gravie’s package includes alternative medicine coverage, generous PTO, up to 16 weeks paid parental leave, paid holidays, a 401k program, transportation perks, education reimbursement, and paid paw-ternity leave. 

 A Little More About Us:

We know healthcare. Our company was founded and is still led by industry veterans who have started and grown several market-leading companies in the space.

We have raised money from top tier investors who share the same long-term vision as we do of building an industry defining company that will endure over the long run. We are well capitalized.

Our clients love us. Customer satisfaction rates among employees using Gravie health plans consistently rank above 80% – nearly 40 points above the industry average.

Our culture is unique. We tend to be non-hierarchical, merit-driven, opinionated but kind people who thrive working in a high-performance, fast-paced environment. People at Gravie care deeply about making a positive impact in the lives of the people we serve. We may not be the right place for everybody, but if you get energized by doing work every day that focuses on putting consumers at the front of the line, we could be a great place for you. It takes unique people and diverse perspectives to deliver our results. We encourage you to be your authentic self – we like you that way.