case manager
3 weeks ago
Will this position be required to work onsite for any reason at any time? No, the resource will be able to perform this role offsite and not required to work onsite.
This position supports SHS/EM/MA Fulfillment required with compact nursing license.
The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs. They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the client's online messaging platform. The Care Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member's health across the care continuum. They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:
1. Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally. The multidisciplinary team is inclusive of Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors.
2. Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members' health across the care continuum.
3. Assess the member's health, psychosocial needs, cultural preferences, and support systems.
4. Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes.
5. Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services).
6. Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
7. Advocate for members and promote self-advocacy.
8. Deliver education to include health literacy, self-management skills, medication plans, and nutrition.
9. Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary.
10. Accurately document interactions that support management of the member.
11. Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
12. Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.
13. Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
14. Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals.
15. Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).
EDUCATION AND EXPERIENCE
1. Nursing Diploma or Associates degree in nursing required.
2. Bachelor's degree in nursing strongly preferred.
3. 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
4. 1 year of case management experience in a managed care setting strongly preferred.
5. Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.
CERTIFICATES, LICENSES, REGISTRATIONS
1. Current, active, and unrestricted Michigan Registered Nurse license required
2. Certification in Case Management (CCM) required or to be obtained within 18 months of hire
3. Certification in Chronic Care Professional (CCP) preferred QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER SKILLS AND ABILITIES
1. Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member's outcomes.
2. Empathetic, supportive and a good listener.
3. Proficient in motivational interviewing skills.
4. Demonstrated time management skills.
5. Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member.
6. Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.).
7. Must embrace teamwork but can also work independently.
8. Excellent interpersonal and communication skills both written and verbal. "
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.
At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.Company DescriptionAbout Kyyba:\r
Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.\r
At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.
-
Case Manager
4 weeks ago
Houston, United States Lowe Law, PLLC Full time $17 - $22Job DescriptionJob DescriptionPersonal Injury firm has opening for EXPERIENCED Personal Injury Case Manager. Candidate must have at least two (2) years of full time personal injury law/case management experience. Candidate will be tasked with obtaining medical records, police reports and handling all aspects of case management from beginning to end,...
-
Case Manager
4 weeks ago
Houston, United States Lowe Law, PLLC Full time $17 - $22Job DescriptionJob DescriptionPersonal Injury law firm has opening for EXPERIENCED Personal Injury Case Manager. Candidate must have at least two (2) years of full time personal injury law/case management experience. Candidate will be tasked with obtaining medical records, police reports and handling all aspects of case management from beginning to end,...
-
Case Manager
2 months ago
Houston, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Case Manager
3 months ago
Houston, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Case Manager
3 days ago
houston, United States Compass Connections Full timeIt's a great feeling to work for a company that does so much good for others around the world!Academic Req: Required – bachelor’s degree in the behavioral sciences, human services, or social services field; Preferred – Graduate degree from accredited program/university in a related field.Certifications: First aid, CPR, Emergency behavior...
-
Case Manager
4 days ago
Houston, United States Compass Connections Full timeIt's a great feeling to work for a company that does so much good for others around the world!Academic Req: Required – bachelor’s degree in the behavioral sciences, human services, or social services field; Preferred – Graduate degree from accredited program/university in a related field.Certifications: First aid, CPR, Emergency behavior...
-
Case Manager
3 days ago
houston, United States Compass Connections Full timeIt's a great feeling to work for a company that does so much good for others around the world!Academic Req: Required – bachelor’s degree in the behavioral sciences, human services, or social services field; Preferred – Graduate degree from accredited program/university in a related field.Certifications: First aid, CPR, Emergency behavior...
-
Case Manager
4 days ago
Houston, United States Compass Connections Full timeIt's a great feeling to work for a company that does so much good for others around the world!Academic Req: Required – bachelor’s degree in the behavioral sciences, human services, or social services field; Preferred – Graduate degree from accredited program/university in a related field.Certifications: First aid, CPR, Emergency behavior...
-
Case Manager
3 months ago
Houston, United States Nexus Health Systems Ltd Full timeJob DescriptionJob DescriptionThe Case Manager is responsible for directing and coordinating the functions and activities of health care services delivery and discharge planning with the multidisciplinary team. The Case Manager facilitates communication and coordination between the health care team members involving both the resident and family in the...
-
Case Manager
1 month ago
Houston, United States Addison Group Full timeLooking for a candidate for one of our clients in the Houston area that has experience as a Litigation Case Manager. This role will include handling litigation cases for a personal injury firm, preparation of case files, communicating with insurance companies, updating all clients' charts, and more as assigned.Requirements3-5 years of handling litigation...
-
Case Manager
1 month ago
Houston, United States Addison Group Full timeLooking for a candidate for one of our clients in the Houston area that has experience as a Litigation Case Manager. This role will include handling litigation cases for a personal injury firm, preparation of case files, communicating with insurance companies, updating all clients' charts, and more as assigned.Requirements3-5 years of handling litigation...
-
Case Manager
1 week ago
houston, United States Collier Legal Search Full timeDowntown Houston Personal Injury Law Firm is seeking a Pre-Litigation Case Manager. Firm has a diverse docket, spanning from MVA, Maritime, Oil and Gas, Product Liability, and more. Firm is on the smaller side with 2 main attorneys, allowing this candidate to be able to get very hands on with the cases.Requirements:MUST have PLAINTIFF litigation...
-
Case Manager
2 weeks ago
Houston, United States Collier Legal Search Full timeDowntown Houston Personal Injury Law Firm is seeking a Pre-Litigation Case Manager. Firm has a diverse docket, spanning from MVA, Maritime, Oil and Gas, Product Liability, and more. Firm is on the smaller side with 2 main attorneys, allowing this candidate to be able to get very hands on with the cases.Requirements:MUST have PLAINTIFF litigation...
-
Case Manager
2 weeks ago
Houston, United States Collier Legal Search Full timeDowntown Houston Personal Injury Law Firm is seeking a Pre-Litigation Case Manager. Firm has a diverse docket, spanning from MVA, Maritime, Oil and Gas, Product Liability, and more. Firm is on the smaller side with 2 main attorneys, allowing this candidate to be able to get very hands on with the cases.Requirements:MUST have PLAINTIFF litigation...
-
RN Case Manager
1 month ago
houston, United States Good Shepherd Hospice Full timeRN Case ManagerRN Case Manager Department: Clinical Employment Type: Full Time Location: Houston, TX Reporting To: Patient Care Manager Description Good Shepherd Hospice is seeking a compassionate candidate for a Register Nurse Case Manager serving patients and their families in Pasadena, Baytown, Pearland with expansion to Texas City and...
-
Case Manager
3 months ago
Houston, United States Memorial MRI & Diagnostic Full timeJob Type Full-time Description Under general supervision administrative personnel, the Case Manger will liaise with the attorneys and record retrieval personnel. Coordinate to ensure that the care plan to treat the patients is carried out properly and that it has the desired result. JOB FUNCTIONS Case Managers are responsible for the maintenance, compliance,...
-
Case Manager
2 months ago
Houston, United States The Callahan Law Firm Full timeJob DescriptionJob DescriptionPlaintiff's Personal Injury law firm seeking an experienced Case Manager to manage a docket of pre-litigation cases. Duties include setting up claims, interacting with clients, assisting with medical care coordination to the extent required, obtaining medical records and bills, and working with the law firm attorneys on...
-
Case Mgr
4 weeks ago
Houston, United States Interim HealthCare Full timeCase Mgr - RN RN Case Manager Home Health-Galveston TX Pearland, TX Interim HealthCare, one of the nation's leading providers of home care, is now seeking an RN Case Manager in the Galveston, TX area to join the team. Expand your career and apply today! Benefits at Interim Healthcare for Case Managers Competent and reliable in- office clinical support team....
-
Director of Case Management
3 weeks ago
Houston, United States Marvel Consultants Full timeWell established healthcare system looking to bring on Director Case Management! This Leader will oversee the program with 10+ Case Managers and Social Workers on the team, while overseeing all protocol for Case Management, Discharge Planning, and Utilization Review. Reports to the CNO.Licensed RN or MSW required.Bachelor of Nursing (BSN) or Masters Social...
-
case manager
3 months ago
Houston, United States KYYBA Full timeJob DescriptionJob DescriptionWill this position be required to work onsite for any reason at any time? No, the resource will be able to perform this role offsite and not required to work onsite.This position supports SHS/EM/MA Fulfillment required with compact nursing license.The Care Manager RN leads the coordination of a multidisciplinary team to deliver...
