RN Case Manager

2 weeks ago

Atlanta, United States Shaker for ChristianaCare Direct Full time

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 coordinate 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.

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