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Registered Nurse Case Coordinator

2 months 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 prominent consulting and professional services organization within the healthcare sector, committed to advancing the future of healthcare. Our focus spans Life Sciences, Revenue Cycle Management, Payers, Technology, and Government sectors, emphasizing excellence and innovation.

Job Overview:

The Community-Based Care Manager is tasked with collaborating with adult individuals and their care teams to formulate a personalized care strategy that addresses their home and community needs. This role involves working alongside an interdisciplinary care team (ICT) to fulfill the requirements 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 of any age enrolled in waiver programs.

Key Responsibilities:

  • Conduct Level of Care assessments to determine member program eligibility 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 arrange for 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 evaluate member progress on the Person-Centered Service Plan (PCSP).
  • 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, safety, and self-care through effective care coordination.
  • Educate members and caregivers about treatment options, community resources, and insurance benefits for informed decision-making.
  • Monitor member satisfaction through open communication and addressing 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 seamless service delivery.
  • Maintain an updated list of medications and assist with medication adherence.
  • Document care coordination activities and member responses in compliance with professional standards.
  • Facilitate interdisciplinary care team meetings to address member needs.
  • Ensure effective communication and collaboration within the interdisciplinary care team to achieve positive outcomes.
  • Engage with members in various settings to establish professional relationships.
  • Adhere to reporting requirements for incidents and prevention planning.
  • Seek process improvements to enhance member experiences.
  • Actively participate in team meetings.
  • Travel regularly for member, provider, and community visits as necessary.
  • Verify Medicaid eligibility on a regular basis.
  • 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 experience is required.
  • Minimum of 1 year of paid clinical experience in home and community-based services is required.
  • Preferred: Three (3) years or more of experience in Medicaid and/or Medicare managed care.
Skills and Competencies:

  • Proficient in Microsoft Office, including Outlook, Word, and Excel.
  • Strong communication skills with diverse groups.
  • Ability to multitask and work independently within a team.
  • Knowledge of healthcare laws, regulations, and company policies regarding case management.
  • 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.
  • Ability to interpret and apply current research findings.
  • Awareness of community and state support resources.
  • Strong critical thinking and decision-making skills.
  • Excellent organizational and time management abilities.
  • Commitment to confidentiality.
  • Capability to transport a laptop and related equipment.
  • Must possess a vehicle for work-related travel and have a valid driver's license.
Licensure and Certification:

  • Current and unrestricted RN license in the State of Ohio is required.
  • Case Management Certification is highly preferred.
  • Valid driver's license, vehicle, and insurance are required. Employment is conditional 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

Expected Hours: 40 per week

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

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