Case Manager RN- Field (Wayne and Macomb Counties) ID-1212

December 10, 2024

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This is a full-time telework role requiring up to 25%-50% travel in Wayne and Macomb counties.

Schedule for this position is Monday-Friday 8:00a-5:00p

Position Summary
Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness.

Fundamental Components

Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness.
Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits.
Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
Collaborates with supervisor and other key stakeholders in the member's healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Required Qualifications

Must have active and unrestricted RN licensure in the state of Michigan
Minimum 3+ years clinical practical experience required
Minimum 2+ years Care Management, discharge planning and/or home health care coordination experience required
Must be willing and able to travel up to 25%-50% in Wayne/Macomb counties. Reliable transportation required. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications

Certified Case Manager
Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills.
Ability to work independently
Effective computer skills including navigating multiple systems and keyboarding
Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications

Education

Associate's Degree or Nursing Diploma required
Bachelor's Degree preferred

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