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WFH Case Manager RN 2

2 months ago

Temple, United States Baylor Scott & White Health Full time

About Us

At Baylor Scott & White Health, we prioritize the health of those - families, and communities. Baylor Scott & White is the biggest non-profit healthcare system in Texas, encouraging a healthy lifestyle.

Our Core Values are:

  • We serve faithfully by doing what's right with a joyful heart.
  • We never settle by constantly striving for better.
  • We are in it together by supporting one another and those we serve.
  • We make an impact by taking initiative and delivering exceptional experience.

Benefits

Our competitive benefits package empowers you to live well and provides:

  • Eligibility on day 1 for all benefits
  • Dollar-for-dollar 401(k) match, up to 5%
  • Debt-free tuition assistance, offering access
    to many no-cost and low-cost degrees, certificates and more
  • Immediate access to time off benefits

At Baylor Scott & White Health, your well-being is our top priority. Visit to learn about all of our programs that supports mind, body and spirit

Note: Benefits may vary based on position type and/or level

Job Summary

As a Case Manager 2, you will primarily manage complex case loads and assist the team and top people with regulations. This may include handling high-risk cases and mentoring new case managers. The role requires attention to detail and a solid knowledge of medical practices and laws.

What You'll Do

  • Managing cases by partnering with clients, families, healthcare providers, and community agencies to create personalized care plans.
  • Advocating for members' needs first.
  • Coordinating affordable, high-quality services that meet care plan requirements and member needs.
  • Identify and report care issues.
  • Use mutual strategies, promote communication.
  • Resolve obstacles for member's benefit.
  • Meeting the production and quality standards as outlined by the management.
  • Passionately helping colleagues to achieve goals and coaching team members as needed.
  • Showing proactive involvement in helping teammates reach their personal and departmental goals.
  • Staying informed on all regulatory and accreditation rules.
  • Ensuring accurate documentation, in line with all federal, state, NCQA, and internal guidelines.
  • Participating in quality auditing and monitoring tasks under the supervision of Health Services managers.
  • Joining or leading regular department meetings.

What Will Make You Successful In The Role

  • Knowing different tools and resources in case management is essential for success in this role.
  • Expected to be up-to-date in understanding of product lines, contracts, networks, systems, and resources.
  • Should be comfortable learning and effectively using case management software, automated systems, and other relevant technologies.
  • Excellent social communication and organizational skills are vital.
  • You should be motivated and able to work efficiently, either autonomously with minimum supervision or as part of a team.
  • The ability to solve intricate problems is also an important attribute for this role.

Belonging Statement

We believe everyone should feel welcome, valued, supported. Our workforce should reflect our communities.

Qualifications

  • Education: Completion of an accredited program.
  • Major: Prospective candidates should have specialized in Nursing.
  • Experience: Candidates should bring a minimum of five years of relevant experience.
  • Certification/License/Registration: Registration as a Nurse is crucial.