RN Case Manager

4 weeks ago

Bakersfield, United States Universal Healthcare MSO LLC Full time
Job DescriptionJob DescriptionDescription:

The Enhanced Care Management (ECM) Case Manager RN, under the supervision of the Case Management Manager, is responsible for addressing the clinical and non-clinical needs of members with the most complex medical and social needs through systematic coordination of services and comprehensive care management. ECM is intended to be interdisciplinary, high touch, person-centered and provided primarily through in-person interactions with members where they live, seek care, and/or prefer to access services. The case manager works with members that have chronic health conditions, are homeless or at-risk, with high hospital admissions, substance abuse, behavioral needs, and/or transitioning from incarceration. Using excellent communication skills, case managers will provide services and coordination with members to ensure continuity of care across health and social service programs and community based and long term-support service (LTSS) programs. This position requires strong interpersonal and organizational skills to build rapport with members, coordinate referrals, and care amongst various healthcare providers and community services. The case manager also works with the member’s inter-disciplinary team (ICT) supporting the member. The case manager engages member and member support systems to define priorities that are central to the member’s desired needs and goals.


Status: Full-Time

Work location: Onsite

Schedule: Monday-Friday 8am-5pm


Compensation:

The initial pay range for this position upon commencement of employment is projected to fall between $40.00 and $45.00. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.

Requirements:

Qualifications

· Licensure: Current California RN license required.

· Experience: Minimum one (1) year as a Registered Nurse in an acute care hospital, mental health setting, clinic outpatient setting, or healthcare agency program.

· Knowledge of: Current principles, techniques and procedures used in professional nursing; medical terminology and patient care routine appropriate to clinical setting; medical instruments and equipment; the uses and effects of medicines and narcotics; community resources available to provide patient care and follow-up; federal, state and local laws and regulations governing professional aspects of nursing; identification of potential discharge needs; payor source documentation requirements and governmental regulations affecting reimbursement.

· Ability to: Perform the full range of nursing duties and responsibilities in a patient care setting; plan, organize and implement nursing plans for patients; prepare and maintain concise and complete records and reports; establish and maintain effective working relationships with physicians, patients and co-workers; secure the cooperation of employees to work effectively together; keep abreast of developments in areas of nursing specialization; teaches, mentors and supervises others routinely; effectively prepare and present reports and recommendations both orally and in written form; evaluate the medical records of hospital admissions; identify discharge needs; collect and evaluate data, draw conclusions and formulate recommendations.

· Related to Mental Health, ability to use individual professionally sound judgment to make complex decisions related to triage; clinical assessments including biopsychosocial evaluation; integration of mental health, chemical dependency, and physical healthcare needs; potential suicidality; placement issues and necessary linkages and supports; and need for emergent psychiatric care and consultation.

· Knowledgeable and skilled in evidenced based communication such as Motivational Interviewing, or similar empathy-based communication strategies.

· Understanding of and sensitivity to multi-cultural community

· Understanding and knowledge of self-management philosophies and practices, especially as they relate to chronic medical conditions.

· Able to sufficiently engage members and providers in person or on the phone.

· Proficiency in data interpretation and demonstrates the ability to learn new information systems and software programs.

· Required attention to detail, analytical thinking skills, excellent technical, interpersonal, and oral communication skills.

· Must be able to work as a member of a highly autonomous team, executing job duties and as an independent team.

· Experience in but not limited to Medicare and Medi-Cal (CMS) environment preferred.

· Strong organizational and time management skills required.

· Must be able to show compassion, empathy, and be sympathetic with nonjudgmental treatment to patients and family or support teams.

· Must be able to use clinical skills to analyze, review and judge different situations patients face and take the required actions according to regulations and expectations, and ethical guidelines.

· Ability to be flexible and work in a changing environment.

· Willingness to collaborate as part of a team with professionals at all levels to achieve goals and remove barriers to member health.

· Sensitivity to members' social, cultural, language, physical, and financial differences.

· Ability to work with members and influence behavior through negotiation of care goals and support of member self-management.

· Strong problem-solving skills and ability to identify issues and propose solutions.

· Ability to prioritize tasks based on changes in member situations and needs.

· Ability to work independently, organize and prioritize multiple tasks throughout the day.

· Strong attention to detail and ability to be accurate, thorough, and persistent in problem-solving and task completion.

· Excellent verbal and written communication skills, with the ability to communicate effectively with all levels of the organization and members.

· Proficiency in creating professional documents with proper grammar and punctuation.

· Ability to maintain professionalism and adapt to a changing environment.

· Ability to understand and communicate complex health and benefit information.

· Proficient in the use of common office technology, including electronic Case Management systems.

· Reliable in attendance and adherence to work schedule and business dress code.

· Ability to always maintain strict confidentiality.


Other Requirements:

· Possession of valid driver’s license

· Proof of state-required auto liability insurance

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