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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 firm within the healthcare sector, committed to advancing the future of healthcare. Our focus spans across 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-based requirements. This role involves working closely with an interdisciplinary care team (ICT) to fulfill the needs of individuals and the broader population, identifying challenges or opportunities that can benefit from coordinated care.

The Care Manager oversees the assessment and management of long-term care clients of any age enrolled in waiver programs.

Key Responsibilities:
  • Conduct Level of Care assessments to establish member program eligibility during initial, annual, and event-based evaluations.
  • Engage members to complete program-specific assessments, considering their cultural and linguistic needs.
  • Identify 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 the member's needs and preferences.
  • Continuously assess and document the member's progress regarding the Person-Centered Service Plan (PCSP).
  • Facilitate and coordinate services based on the care treatment plan developed with all stakeholders.
  • Regularly evaluate care/service plans through communication with members, families, providers, and stakeholders.
  • Identify and address barriers to achieving care plan objectives.
  • Implement effective interventions grounded in clinical standards and best practices.
  • Empower members to manage and enhance their health, wellness, safety, and self-care through effective care coordination and case management.
  • Educate members and caregivers about treatment options, community resources, and insurance benefits to enable informed decision-making.
  • Assess member satisfaction through open communication and monitoring of concerns.
  • Collaborate with facility-based case managers and providers to plan for post-discharge care needs or facilitate timely transitions to appropriate care levels.
  • Coordinate with community-based case managers and service providers to ensure effective service coordination and avoid duplication.
  • Maintain an updated list of medications and assist with medication adherence.
  • Document care coordination activities and member responses promptly, adhering to professional documentation standards.
  • Organize interdisciplinary care team meetings to address member needs.
  • Foster communication and collaboration among interdisciplinary care team members to achieve goals and optimize member outcomes.
  • Engage with members in various settings to establish effective professional relationships.
  • Comply with reporting requirements for incidents and prevention planning.
  • Seek process improvements to enhance the member experience with CareSource.
  • Actively participate in team meetings.
  • Travel regularly to conduct member, provider, and community-based visits as necessary.
  • Verify Medicaid eligibility consistently.
  • Fulfill on-call responsibilities as assigned.
  • Perform additional job duties as required.
Qualifications:
  • Nursing degree from an accredited program or a Bachelor's degree in a healthcare field, or equivalent relevant 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 Suite, including Outlook, Word, and Excel.
  • Strong communication skills with diverse groups.
  • Ability to manage multiple tasks and work independently within a team.
  • Knowledge of healthcare laws, regulations, and company policies related to 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 case, requiring the ability to lift/carry at least 20 pounds.
  • Must possess a vehicle and valid driver's license for work-related travel.
Licensure and Certification:
  • Current and unrestricted RN license, LSW, or LISW in the State of Ohio is required.
  • Case Management Certification is highly preferred.
  • Valid driver's license, vehicle, and insurance are mandatory. Employment is contingent upon successful clearance of a driver's license record check and criminal background check.

Job Types:
Full-time, Contract

Compensation:
Starting at $40.00 per hour

Expected Hours: 40 hours 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