Job Overview:
We are seeking a dedicated and compassionate Registered Nurse Case Manager to join our team. This role plays a vital part in delivering high-quality patient care while ensuring efficient utilization of healthcare resources. As a Registered Nurse Case Manager, you will coordinate patient care across various healthcare settings, provide education and support to patients and their families, and promote positive health outcomes.
Fundamental Components & Physical Requirements
- 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 that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
- 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, and determination of eligibility for benefits as appropriate.
- Prepares all required documentation of case work activities as appropriate.
- May make outreach to treating physicians or specialists concerning the course of care and treatment as appropriate.
- Provides educational and prevention information for best medical outcomes.
- Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.
- Utilizes case management processes in compliance with regulatory and company policies and procedures.
- Develop a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration.
- Monitors member/client progress toward desired outcomes through assessment and evaluation.
Required Qualifications
· Minimum 3-5 years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
· Minimum 2-3 years CM, discharge planning and/or home health care coordination experience
· Effective communication, organizational, and interpersonal skills.
· Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
· • Efficient and Effective computer skills including navigating multiple systems and keyboarding
Education
- Registered Nurse with active state license in good standing within the region where job duties are performed is required.
A Certified Case Manager is preferred.
Job Type: Full-time
Pay: From $45.00 per hour
Expected hours: No less than 40 per week
Benefits:
- 401(k)
- Dental insurance
- Disability insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Mileage reimbursement
- Paid sick time
- Tuition reimbursement
- Vision insurance
Medical specialties:
- Cardiology
- Home Health
- Hospice & Palliative Medicine
- Primary Care
Schedule:
Work setting:
Experience:
- Nursing: 3 years (Required)
- Case management: 3 years (Required)
License/Certification:
Ability to Commute:
Willingness to travel:
Work Location: On the road