RN Case Manager -Downers Grove

Overview

RN Case Manager - Care Ally - Plainfield Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. to 5:00 p.m.; flexibility to work later as needed

Benefits

Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider. Employer provided life and disability insurance. $5,250 Tuition Reimbursement per year. Immediate 401(k) match. 40 hours paid volunteer time off. A culture committed to community engagement and social impact. Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

Responsibilities

• The RN Case Manager - Care Ally works in collaboration with physicians, patients and families to promote quality outcomes for patients with complex medical needs.
• The Case Manager is responsible for increasing efficient utilization of health care services; identifying chronic or catastrophic cases through the case management process and initiating intensive case management according to program guidelines.
• The Case Manager is responsible for managing patients in all health care settings to assure the appropriate level-of-care is provided, to prevent inpatient re-admissions and ensure that the patients' medical, environmental and psychosocial needs are met over the continuum of care.
• The Nurse Case Manager acts as an advocate through the coordination and communication with the health care team and family regarding care planning and implementation of recovery goals.
• In addition, the case manager will assess and coordinate resources available to patients and maximize the use of health care benefits.
• Analyze data collected from the 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.
• In addition, complete all documentation, member communications, and case closures per policies and procedures.
• Proficient in knowledge of current Case Management Standards Coordinate Health Care Services with appropriate physicians and health care providers.