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Case Manager II
2 months ago
The RN Case Manager II plays a vital role in providing comprehensive integrated case management for SCO members with complex needs and/or catastrophic illness or injury. This position ensures cost-effective and efficient utilization of health services, while in a healthcare institution such as a hospital, rehab facility, or skilled nursing facility.
Key Responsibilities:- Collaborate with treating physicians, ancillary providers, and family/caregivers to develop prioritized long/short-range goals.
- Match patients' care needs to available resources, ensuring members stay at appropriate levels and make adjustments when necessary.
- Assess clinical information to develop treatment plans and appropriate outcomes.
- Identify cases with potential for high-risk complications and serve as an advocate for members' healthcare needs.
- Evaluate the quality of necessary medical services and identify cases that would benefit from alternative care.
- Recommend opportunities to maximize cost-effectiveness.
- Registered Nurse currently licensed in the Commonwealth of MA.
- Bachelor's Degree (preferred) in a related Health/Nursing field.
- Minimum of 5 years relevant experience in healthcare and/or case management.
- Experience working on the community level and with community agencies preferred.
- Eligible for Case Management Certification.
- Proficient in the use of MS Office tools.
- Experience working with case management data systems.
- Able to travel locally on a frequent basis.
Element Care is an Equal Opportunity Employer.
