RN Case Manager

2 weeks ago

Cleveland, United States Shaker for ChristianaCare Direct Full time

RN Case Manager - CareVio - Cardio-Pulmonary 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 Cardio-Pulmonary. 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.

Cardio-Pulmonary Care Coordinator role:

  • Strong knowledge base in COPD (Chronic Obstructive Pulmonary Disease) and Heart Failure and symptom management
  • 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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