Nurse Care Coordinator

4 days ago


Carol Stream, Illinois, United States Duly Health and Care Full time

About the Role:

The RN Case Manager - Care Ally at Duly Health and Care works collaboratively with physicians, patients, and families to promote quality outcomes for patients with complex medical needs.

Key Responsibilities:

  • Increasing efficient utilization of healthcare services
  • Managing patients in all healthcare settings to ensure the appropriate level of care is provided
  • Preventing inpatient re-admissions and ensuring patients' medical, environmental, and psychosocial needs are met
  • Acting as an advocate through coordination and communication with the healthcare team and family regarding care planning and implementation of recovery goals
  • Analyzing data collected from predictive modeling tools to identify eligible patients for the Case Management Program
  • Enrolling and managing a caseload of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements
  • Developing individualized case management plans with prioritized goals and appropriate interventions in compliance with risk stratification level requirements
  • Completing all documentation, member communications, and case closures per policies and procedures
  • Coordinating healthcare services with appropriate physicians and healthcare providers
  • Managing and providing a comprehensive summary and log of all active Case Management Cases as required by the UM/QA Committee and/or Health Plan
  • Acting as a resource for Utilization Management Staff, physicians, office staff, and patients
  • Assisting with the evaluation and amendment of Case Management Policy and Procedures
  • Attending continuing education sessions and training relating to job functions as required

Requirements:

  • Associate's degree in nursing required; Bachelor's degree in nursing preferred
  • 2-4 years of experience working within the primary care or hospital setting as a Registered Nurse

About Duly Health and Care:

Duly Health and Care is a healthcare organization committed to providing high-quality care to patients with complex medical needs. We are seeking a dedicated and compassionate RN Case Manager to join our team.



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