RN Case Manager

2 days ago


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

We are seeking a skilled RN Case Manager to join our team at Duly Health and Care. As a RN Case Manager, you will work collaboratively with physicians, patients, and families to promote quality outcomes for patients with complex medical needs.

Key Responsibilities
  • Analyze data from predictive modeling tools to identify eligible patients for the Case Management Program.
  • Enroll and manage a caseload 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.
  • Act as a resource for Utilization Management Staff, physicians, office staff, and patients.
  • Assist with the evaluation and amendment of Case Management Policy and Procedures.
  • Attend continuing education sessions and training relating to your job functions as required.
Requirements
  • 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).
  • 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.
  • Previous experience working within case management preferred.

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