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RN Case Manager
4 weeks ago
As a RN Case Manager at Duly Health and Care, you will work in collaboration with physicians, patients, and families to promote quality outcomes for patients with complex medical needs. Your primary responsibility will be to increase efficient utilization of healthcare services, identify chronic or catastrophic cases through the case management process, and initiate intensive case management according to program guidelines.
Key Responsibilities
- Analyze data collected from predictive modeling tools to identify eligible patients for the Case Management Program.
- Enroll and manage a case load of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements.
- Develop individualized case management plans with prioritized goals and appropriate interventions in compliance with the risk stratification level requirements.
- Coordinate healthcare services with appropriate physicians and healthcare providers.
- Manage and provide a comprehensive summary and log of all active Case Management Cases as required by the UM/QA Committee and/or Health Plan.
Qualifications
- Must be an active Registered Nurse License in the State of Illinois in good standing.
- Certification in Case Management, preferred.
- Current CPR certification must be maintained (BLS).
