Nurse Care Coordinator
4 days ago
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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