Healthcare Case Manager
4 days ago
Job Title: Clinical Case Manager
Location: Remote (Washington, Indiana) **Must be an Indiana Resident (remote, but field visits are required)
Hours: Monday - Friday 8am-5pm
Pay: $48 hourly | Weekly pay
Job Summary:
The Community Well Care Coordinator must oversee the care coordination, complex case management functions for PathWays to Aging members who live in the community and who are not receiving Home and Community Based Services (HCBS) or designated as Nursing Facility Level of Care (NFLOC).
Primary Responsibilities:
• Assess, plan and implement care strategies that are individualized by patient and directed toward the most appropriate, least restrictive level of care.
• Identify and initiate referrals for social service programs; including financial, psychosocial, community and state supportive services.
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members.
• Advocate for patients and families as needed to ensure the patient’s needs and choices are fully represented and supported by the health care team.
• Collaborates across Optum and interact with Medical Directors, Site Directors, Senior Leaders, Network, and other stakeholders.
Required Qualifications:
• Resident of Indiana
• BSN with equivalent experience
• Registered Nurse with an unrestricted License in Indiana
• Experience working within the community health setting in a health care role
• Experience or knowledge of Indiana Medicaid, Medicare, Long term care
• Intermediate level of experience with Microsoft Word, with the ability to navigate a Windows environment
Preferred Qualifications:
• 3+ year of case management leadership experience within a healthcare industry
• Background in managed care
• Case Management experience
• Certified Case Manager (CCM)
• Experience / exposure with members receiving long term social supports
• Experience in utilization review, concurrent review and/or risk management
PME is an equal opportunity employer. We prohibit discrimination and harassment against any applicant or employee based on any legally recognized basis, including, but not limited to: veteran status, uniformed servicemember status, race, color, religion, sex, sexual orientation, gender identity, age (40 and over), pregnancy, national origin or ancestry, citizenship status, physical or mental disability, genetic information (including testing and characteristics) or any other category protected by federal, state or local law.
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