RN Case Manager

4 weeks ago

Lisle IL, United States Dupage Medical Group Full time

RN Case Manager - Care Ally

Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. Duly Health and Care's team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our work.
Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. Holistic benefits designed to help our team members flourish in all aspects of their lives, including:
* Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider.
* $5,250 Tuition Reimbursement per year.
* A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact
* 12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members.
* The RN Case Manager - Care Ally works in collaboration with physicians, patients and families to promote quality outcomes for patients with complex medical needs. The Case Manager is responsible for increasing efficient utilization of health care services; The Case Manager is responsible for managing patients in all health care settings to assure the appropriate level-of-care is provided, to prevent inpatient re-admissions and ensure that the patients' medical, environmental and psychosocial needs are met over the continuum of care. The Nurse Case Manager acts as an advocate through the coordination and communication with the health care team and family regarding care planning and implementation of recovery goals. In addition, the case manager will assess and coordinate resources available to patients and maximize the use of health care benefits.
Analyze data collected from the predictive modeling tools to identify eligible patients for the Case Management Program.
* Enroll and manage a case load of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements.
* Develop individualized case management plans with prioritized goals and appropriate interventions in compliance with the risk stratification level requirements. In addition, complete all documentation, member communications, and case closures per policies and procedures.
* Coordinate Health Care Services with appropriate physicians and health care providers.
* Manage and provide a comprehensive summary and log of all active Case Management Cases as required by the UM/QA Committee and/or Health Plan.
* Act as a resource for Utilization Management Staff, physicians, office staff and Patients.
* Assist with the evaluation and amendment of Case Management Policy and Procedures
* Attend continuing education sessions and training relating to your job functions as required.
* Associate's degree in nursing required; Bachelor's degree in nursing preferred.
2-4 years of experience working within the primary care or hospital setting as a Registered Nurse.
*

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