Case Manager, Registered Nurse
Job Description:
• Help us elevate our patient care to a whole new level!
• Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models.
• Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.
• Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.
• Interacts with members/clients telephonically or in person.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning.
• Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
• Prepares all required documentation of case work activities as appropriate.
• Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
Requirements:
• Candidate must have active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida
• 3+ years of clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, Home Health) with Medicare members
• 2+ years of case management, discharge planning and/or home health care coordination experience
• Proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
• Able to work in a fast paced high volume environment and utilize time management and prioritization skills.
• Efficient and effective computer skills including navigating multiple systems and keyboarding
• Preferred Qualifications Bilingual - Spanish
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Certified Case Manager
• National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
Apply tot his job
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• Help us elevate our patient care to a whole new level!
• Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models.
• Community Care Case Manager use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.
• Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care.
• Interacts with members/clients telephonically or in person.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning.
• Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
• Prepares all required documentation of case work activities as appropriate.
• Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.
Requirements:
• Candidate must have active and unrestricted Compact Registered Nurse (RN) Licensure in Alabama, Arkansas, Maryland, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, Georgia, or Florida
• 3+ years of clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac, Home Health) with Medicare members
• 2+ years of case management, discharge planning and/or home health care coordination experience
• Proficiency with standard corporate software applications, including Microsoft Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
• Able to work in a fast paced high volume environment and utilize time management and prioritization skills.
• Efficient and effective computer skills including navigating multiple systems and keyboarding
• Preferred Qualifications Bilingual - Spanish
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Certified Case Manager
• National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
Apply tot his job
Apply To this Job