Bright Health
Through powerful relationships with care partners, Bright Health aims to help people live healthier and brighter lives
Austin, TX
Remote

Complex Care Nurse/Nurse Supervisor at Bright Health

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Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.

What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.

If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.


The Complex Care Nurse/Nurse Supervisor leads a team of clinicians and support staff in the delivery of care coordination and case management services to Medicare Advantage Special Needs Program members. This individual is accountable for the execution of program services according to program specifications to improve care outcomes via interaction with Bright members, their providers and available member support services. This role embodies a philosophy that maintains focus on members’ health, leading by serving as an example to assure members and providers have a positive experience with the services they receive. The Complex Care Nurse/Nurse Supervisor ensures all related initiatives meet all applicable state and/or federal regulatory requirements in addition to corresponding URAC and NCQA standards.

ROLE RESPONSIBILITIES
The Complex Care Nurse/Nurse Supervisor job description is intended to point out major responsibilities within the role, but it is not limited to these items.

• Provide leadership and direction to a team of clinicians and support staff, responsible for the development and completion of personal care plans.
• Coordinate with the Clinical Programs team and Program Management team with respect to program design, efficiency, efficacy and member/provider satisfaction.
• Support the development and maintenance of standard operating procedures related to corresponding clinical program functions.
• Collects, organizes, and analyzes data, synthesizing it into an understandable, clear and concise language and provides electronic documentation that meets regulatory requirements.
• Organizes data and reports for ICT meetings on regular basis for their designated population.
• Participate in the development of operating models to execute clinical program solutions, including but not limited to Complex Case Management, Disease Management and Transitions of Care
• Provides guidance to the health coach on topics such as health maintenance, medication management, and disease management
• Collaborate with Provider Relations, Market Management teams and Care Partner representatives in the management of members’ care plans.
• Assists in identifying members’ appropriateness for other programs.
• Reviews medical records for their designated population, as well as lab and medication data, and determines risk level appropriateness.
• Works with outside facilities, agencies, and stakeholders on a routine basis, maintaining positive working relationships to support care coordination.
• Conduct outbound interventions to support to advance member care plans, coordinate care and close clinical gaps.
• Assist the member by arranging follow-up appointments to see the specialist or PCP, as needed.
• Coordinate care for members, with specialists, and assisting with LOA’s for continuity of care issues, and tertiary care needs.
• Refer members to community resources and assist as need to apply for financial and other programs.
• Work with assigned Health Nurse to coordinate home visits as needed, and to coordinate calls to members.
• Effectively communicates, problem-solves, and maintains productive and effective interpersonal relationships.
• Supports the administrative efforts of the Care Management Programs department.
• Recruit, hire and train new team members.


SUPERVISORY RESPONSIBILITIES
This position has supervisory responsibilities for members of the Care Management team assigned to supporting Care Coordination and Case Management activities.


EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
• Bachelor’s degree in Nursing or related field is required
• Five (5) or more years of experience working within Case Management and/or Care Coordination functions
• Two (2) or more years of management experience
• Prior experience with URAC accreditation is desired
• Formal training in Six Sigma management techniques is a plus, but not required
• Bilingual in English and Spanish is preferred


PROFESSIONAL COMPETENCIES
• Ability to evaluate complicated problems and isolate contributing factors
• Capable communicator that can interact with others at multiple levels within the organization
• Leads through influence and example
• Strong operational mindset and use data to draw insights
• Thrives on driving results in a collaborative environment

LICENSURES AND CERTIFICATIONS
• An active, unrestricted Registered Nurse (RN) license is required

WORK ENVIRONMENT
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel, up to 10% of the time may be required.

 
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
 
Focusing on Consumers
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
 
Building on Alignment
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
 
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
 
          
 
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
 

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Where we are

We are downtown at 515 Congress Avenue, right in the heart of downtown! Tons of restaurants and close to public transportation.

Technology we use

  • Engineering
  • Product
  • Sales & Marketing
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What are Bright Health Perks + Benefits

Bright Health Benefits Overview

We have 2 different health insurance plans, all through BlueCross Blue Shield (HDP & PPO). We cover the majority of the cost for the employee and some cost for family. We have two dental plans and a vision plan as well. We have a Lifestyle Spending Account and options for HSA/FSA. We put 4% of your total earnings into your 401K plan and you are immediately vested. We have all the latest technology (Mac or Surface laptops – your choice) to use including standing desks. Fully stocked fridge with snacks and drinks. Last Wednesday of every month is reserved for WellBeing Wednesday where we don't schedule any meeting that day so our employees can focus on deep work or learning something new.

Culture
Volunteer in local community
Partners with Nonprofits
Friends outside of work
Eat lunch together
Daily sync
Open door policy
Team owned deliverables
Team based strategic planning
Group brainstorming sessions
Pair programming
Open office floor plan
Diversity
Dedicated Diversity/Inclusion Staff
Unconscious bias training
Diversity Employee Resource Groups
Hiring Practices that Promote Diversity
Health Insurance & Wellness Benefits
Flexible Spending Account (FSA)
Disability Insurance
Dental Benefits
Vision Benefits
Health Insurance Benefits
Life Insurance
Wellness Programs
Bright Health is proud to offer a wellness stipend of $200/month to all employees!
Onsite Gym
Mental Health Benefits
Retirement & Stock Options Benefits
401(K)
We will put 3% of your total earnings into your 401K plan, even if you don't put anything in. It's a safe harbor contribution.
401(K) Matching
Bright Health provides employees with a 401(k) plan managed by Vanguard. We provide a ‘safe harbor’ non-elective contribution equal to 3% of your compensation, regardless of participation in the p
Performance Bonus
Child Care & Parental Leave Benefits
Generous Parental Leave
We provide up to 6 weeks of parental leave for the primary caretaker. We also provide 2 weeks of leave for the secondary caretaker.
Flexible Work Schedule
Bright Health provides employees with a flexible work schedule that includes Core hours, Flexible start and end times.
Remote Work Program
Family Medical Leave
Vacation & Time Off Benefits
Generous PTO
Paid Holidays
Paid Sick Days
Perks & Discounts
Casual Dress
Commuter Benefits
Stocked Kitchen
Happy Hours
Happy hours are hosted on occasion.
Relocation Assistance
Fitness Subsidies
Bright Health employees are eligible for discounts on several gym memberships.
Home Office Stipend for Remote Employees
Professional Development Benefits
Tuition Reimbursement
Diversity Program
Lunch and learns
Cross functional training encouraged
Promote from within
Time allotted for learning
Online course subscriptions available
Customized development tracks

Additional Perks + Benefits

Bright's primary goal is to offer employee benefits and perks that are as flexible as possible to meet each employee's unique needs!

An Insider's view of Bright Health

What’s the vibe like in the office?

The office has a relaxed and laid back vibe but people are very serious about their work - perfect!

Anthony

Data Engineer

What does your typical day look like?

My day is so varied, given how quickly we're growing, which is fulfilling for me. I have a good balance of strategic and tactical work in my day as well as time to focus and time to collaborate.

Jen

VP, Digital

What makes someone successful on your team?

A hard-working team player who thinks first and codes next is likely to learn a lot and quickly become a valuable member of the team. Lots of experience with some of our tooling is always nice, but if someone can't knowledge-share well or responds poorly to code reviews and other requests for collaboration, it'll be a tough fit.

Brian

Software Engineer 3

How do your team's ideas influence the company's direction?

We hire smart individuals who thrive on accomplishment and purpose. Our teams are exposed to the bigger picture through constant communication and dialogues – that encourages them to come up with innovative solutions to problems. We've made significant adjustments on our direction in technology and process that were initiated by the team.

Abdullah

VP, Engineering

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