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RN Case Manager
2 months ago
RN Case Manager - CareVio - Maternity Care
Day Shift (Hours: M-F 8-4:30p with 1-2 Evening Shift per week: 8-8 pm)
Wilmington, DE
ChristianaCare CareVio is hiring an RN Case Manager for Longitudinal Care Coordination for Maternity. The RN will c oordinate the utilization of healthcare resources, including transition planning, and facilitate the achievement of clinical, quality, financial, and member satisfaction goals.
Maternity Care Coordinator role:
- Strong knowledge base in high-risk pregnancy with co-morbid conditions, newborns, and significant social determinants of health issues
- The position is hybrid supporting in-office and remote work.
- 1-2 Evenings are required weekly until 8:00 pm
Scope And Frequency of Contacts:
Ongoing contact with members and multidisciplinary care team including CareVio case managers, Providers, Payers, Inpatient Case Managers, and alternate level of care settings staff.
The Principal Duties and Responsibilities:
- Perform ongoing telephonic case management activities of assessment, problem identification, planning, implementation, coordination, monitoring, and evaluation of case-managed members.
- Collaborates with patients, caregivers, and members of the multi-disciplinary care team to develop a member-centered plan of care to meet identified member care goals and outcomes.
- Develop, implement, evaluate, and revise case management care plans according to case management eligibility criteria, contractual guidelines, and members' physical and psychological needs throughout the continuum of care.
- Identifies system issues that serve as barriers to care. Participates in the development and implementation of strategies to remove barriers and promote resolution through the coordination of a problem-solving process.
- Promote member wellness and autonomy through advocacy, communication, education, and identification and referral to community resources or other case management programs such as disease management programs.
- Identify appropriate providers and facilities through the continuum of services and ensure that available resources are being used in a timely and cost-effective manner.
- Collaborate with transitional, embedded, and inpatient case managers in the discharge and transitional care process, obtaining and/or coordinating appropriate resources for members throughout the continuum of care.
- Stratifies and/or validates member's level of risk during each transition process and interaction with the member.
- Collaborates with health care providers in settings not limited to the PCP office, hospital, skilled nursing facility, or home care agencies to assist members in coordinating safety.
Education & Special Requirements:
- DE RN License or Compact Nursing License
- BSN is required or a commitment to obtain within 3 years of the hire date.
- 2-5 years relevant experience in Utilization Management or Case Management.
- The ability to obtain a non-compact state RN Licensure as needed.
- Active Basic Life Support (BLS) certification
- Case Management Certification is preferred through the Commission for Case Management (CCM) within 18 months of eligibility.
- Advanced Certification is recommended.
PHYSICAL DEMANDS:
Ability to ambulate within an office setting (walking, stairs, etc.)
Occasional sitting, standing, and lifting loads of 5-10 pounds.
