Care Manager RN

2 weeks ago

Detroit, Michigan, United States w3r Consulting Full time
Job Title: Care Manager RN

Join w3r Consulting as a Care Manager RN and lead the coordination of a multidisciplinary team to deliver a holistic, person-centered care management program to a diverse health plan population.

Key Responsibilities:
  • Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonically and/or digitally.
  • Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members' health across the care continuum.
  • Assess the member's health, psychosocial needs, cultural preferences, and support systems.
  • Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promote improved overall health outcomes.
  • Arrange resources necessary to meet identified needs, including community resources, mental health services, substance abuse services, financial support services, and disease-specific services.
  • Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
  • Advocate for members and promote self-advocacy.
  • Deliver education to include health literacy, self-management skills, medication plans, and nutrition.
  • Monitor and evaluate the effectiveness of the care management plan, assess adherence to the care plan to ensure progress to goals, and adjust and reevaluate as necessary.
  • Accurately document interactions that support the management of the member.
  • Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
  • Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
  • Adhere to professional standards as outlined by protocols, rules, and guidelines, meeting quality and production goals.
  • Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM) certification.
Requirements:
  • Nursing Diploma or Associates degree in nursing required.
  • Bachelor's degree in nursing strongly preferred.
  • 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
  • 1 year of case management experience in a managed care setting strongly preferred.
  • Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.
Qualifications:
  • Current, active, and unrestricted Michigan Registered Nurse license required.
  • Certification in Case Management (CCM) required or to be obtained within 18 months of hire.
  • Certification in Chronic Care Professional (CCP) preferred.

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