Case Manager - RN, Remote - Case Management
Company: Dupage Medical Group
Location: Downers Grove
Posted on: April 22, 2024
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Job Description:
Case Manager - RN, Remote
Overview
RN Case Manager - Care Ally
* Full-Time, 40 hours per week. Monday through Friday, 8:00 a.m. to
5:00 p.m.; flexibility to work later as needed
Good enough isn't for us. Duly Health and Care's team members show
up every day driven to exceed expectations. We see and support the
remarkable in every person within and beyond the walls of our
work.
Duly Health and Care works to understand what matters most to you.
We recruit and retain team members who share a relentless passion
and pride for helping others live happier and healthier lives. We
invest in helping our team members develop their talents in a way
that is rich in personal meaning. We invite you to join us, fulfill
your purpose and make your mark!
Holistic benefits designed to help our team members flourish in all
aspects of their lives, including:
* Comprehensive medical and prescription drug benefits that include
medical coverage at 100% (after deductible) when utilizing a Duly
provider.
* $5,250 Tuition Reimbursement per year.
* 40 hours paid volunteer time off.
* A culture committed to Diversity, Equity, and Inclusion (DEI) and
Social Impact
* 12 Weeks parental leave at 100% pay and a financial benefit for
adoption and surrogacy for non-physician team members.
* 401(k) Match
* Profit-sharing program
Responsibilities
Are you ready to challenge the expected to deliver the
extraordinary?
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.
The Journeys and Adventures that Await
* 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.
* 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.
* Perform additional duties/tasks as assigned.
Qualifications
The Experiences You Bring
* Must be an active Registered Nurse License in the State of
Illinois in good standing.
* Certification in Case Management, preferred
* 2-4 years of experience working within the primary care or
hospital setting as a Registered Nurse.
* Current CPR certification must be maintained (BLS).
* Previous experience working within case management preferred.
Keywords: Dupage Medical Group, Lombard , Case Manager - RN, Remote - Case Management, Executive , Downers Grove, Illinois
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