Registered Nurse Case Coordinator

2 weeks ago

Columbus, Ohio, United States Medasource Full time
Position:
  • Case Manager RN
Location:
  • Hybrid Work From Home / Community Based
Duration: 6 Month Contract, Potential to Extend or Hire Full-Time

Company Overview: Medasource is a premier consulting and professional services firm in the healthcare sector, committed to advancing the future of healthcare. We focus on delivering excellence and innovation across Life Sciences, RCM/Payers, Technology, and Government sectors.

Job Overview:

The Community Based Care Manager is tasked with collaborating with adult individuals and their care teams to formulate a personalized care plan that addresses their home and community-based requirements. This role involves working closely with an interdisciplinary care team (ICT) to fulfill the needs of both the individual and the broader population, identifying issues or opportunities that could benefit from coordinated care.

The Care Manager is accountable for the assessment and management of long-term care clients enrolled in waiver programs.

Key Responsibilities:
  • Conduct Level of Care assessments to determine eligibility for member programs during initial, annual, and event-based evaluations.
  • Engage members to complete program-specific assessments, considering their cultural and linguistic needs.
  • Assess service requirements, authorize services, and coordinate service delivery.
  • Develop and implement comprehensive, person-centered care/service plans in collaboration with the interdisciplinary care team, tailored to member needs and preferences.
  • Perform ongoing assessments and documentation to track member progress on the care plan.
  • Facilitate and coordinate services based on the treatment plan developed with all stakeholders.
  • Continuously evaluate care/service plans through communication with members, families, providers, and stakeholders.
  • Identify and address barriers to achieving care plan objectives.
  • Implement effective interventions based on clinical standards and best practices.
  • Empower members to manage and enhance their health, wellness, and self-care through effective case management.
  • Educate members and caregivers about treatment options, community resources, and insurance benefits.
  • Monitor member satisfaction through open communication and address any concerns.
  • Collaborate with facility-based case managers and providers to plan for post-discharge care needs.
  • Coordinate with community-based case managers and service providers to ensure effective service delivery.
  • Maintain an updated list of medications and assist with medication adherence.
  • Document care coordination activities and member responses in accordance with professional standards.
  • Facilitate interdisciplinary care team meetings to address member needs.
  • Foster communication and collaboration among interdisciplinary care team members to achieve optimal outcomes.
  • Engage with members in various settings to establish professional relationships.
  • Adhere to reporting requirements for incidents and harm prevention.
  • Seek opportunities to enhance processes for improved member experiences.
  • Actively participate in team meetings.
  • Travel regularly for member, provider, and community visits as necessary.
  • Verify Medicaid eligibility consistently.
  • Fulfill on-call responsibilities as assigned.
  • Perform additional duties as required.
Qualifications:
  • Nursing degree from an accredited program or Bachelor's degree in a healthcare field, or equivalent relevant experience.
  • Minimum of 1 year of paid clinical experience in home and community-based services.
  • Preferred: Three or more years of experience in Medicaid and/or Medicare managed care.
Skills and Competencies:
  • Proficient in Microsoft Office applications, including Outlook, Word, and Excel.
  • Strong communication skills with diverse populations.
  • Ability to multitask and work independently within a team.
  • Knowledge of healthcare laws, regulations, and case management practices.
  • Adherence to ethical standards in professional practice.
  • Familiarity with Case Management Society of America (CMSA) standards.
  • Advocacy for members at all care levels.
  • Respect for cultural and demographic diversity.
  • Critical thinking and decision-making skills.
  • Strong organizational and time management abilities.
  • Capability to maintain confidentiality.
  • Must possess a valid driver's license and have access to a vehicle for work purposes.
Licensure and Certification:
  • Current and unrestricted RN license in the State of Ohio required.
  • Case Management Certification is highly preferred.
  • Employment is contingent upon successful clearance of a driver's license record check and criminal background check.

Job Types:
Full-time, Contract

Compensation:
From $40.00 per hour

Benefits:
  • 401(k) matching
  • Dental, Health, Life, and Vision insurance
  • Paid time off

Schedule:
  • 5x8
  • 8-hour shifts
  • Monday to Friday
  • Morning shifts
  • No weekends

Experience:
Community Based Case Management: 1 year (Required)
Medicaid Waiver: 1 year (Preferred)

License/Certification:
  • RN License (Required)
  • Driver's License (Required)

Work Location:
On the road

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