RemoteRemote candidates must reside in North Carolina or Florida.
No H1B Sponsorship
About the job
Requirements
An active, current, unrestricted Registered Nurse license in a Nurse Licensure Compact state is required.
Case Management Certification (CCM) is required; candidates without certification must obtain it within three years of starting employment.
Three years of clinical Registered Nurse experience in a medical/surgical or ambulatory care setting is required.
Clinical knowledge of the health or social work needs of the population served.
Ability to identify barriers to a successful care management path.
Ability to interact effectively with physicians and other members of the health care team.
Problem-solving, time-management, written communication, verbal communication, and interpersonal communication skills.
Ability to complete job duties independently and proficiently, with flexibility in work schedules and assignments.
Examples of displaying Nova’s Core 4: Act with Passion, Work Together, Be Accountable, and Build Trust.
Knowledge of the scope of practice of multi-state licensure and ability to practice accordingly.
Responsibilities
Apply the six essential activities of case management—assessment, planning, implementation, coordination, monitoring, and evaluation—through quality-improvement functions involving processes, relationships, health care management, community resources and support, service delivery, and psychosocial intervention.
Assess patients’ immediate and long-term needs by evaluating their social and medical histories.
Develop plans of care based on clinical assessments from patients and providers, considering physical and psychosocial needs, benefit plans, and cost-benefit factors affecting optimal recovery.
Continuously evaluate and update plans of care as patient needs change, and monitor care quality and effectiveness for all members of the interdisciplinary team.
Ensure compliance with regulatory and privacy standards, prompt payment and reimbursement, and appeals processes; coordinate decisions and documentation; and maintain a current, accurate database.
Establish professional working relationships with interdisciplinary team members and communicate case objectives to appropriate parties.
Act as a patient advocate by identifying potential complications and understanding methods for assessing the current and future physical and psychosocial characteristics of illnesses.
Read, understand, and apply principles of the Americans with Disabilities Act and understand federal legislation affecting individuals with disabilities.
Maintain knowledge of assistive and adaptive equipment.
Establish support systems and research and interview community resources to help patients achieve psychological, social, and physical recovery.
Communicate available services and resources to patients and assist them in obtaining services for their immediate and future needs.
Identify cases that may benefit from alternative care by assessing patient needs and available resources.
Work with payors, providers, and team members to evaluate service quality and cost effectiveness, and negotiate cost discounts when appropriate.
Identify cases that may benefit from alternative levels of care and resources, such as rehabilitation facilities and home health care providers; implement alternatives considering care quality and patients’ current and ongoing needs.
Apply case management concepts, including roles, philosophies, principles, liability, and confidentiality, to develop appropriate plans of care and goals based on patient needs.
Apply problem-solving techniques to case management, analyze and evaluate outcomes, and implement alternatives when appropriate.
Document patients’ plans of care in a timely manner.
Maintain professional standing in the community through professional organization membership and/or continuing education.
Participate in training and education committees as assigned and provide input into support staff orientation and training relevant to the Case Manager role.
Provide support, guidance, and direction to support staff as indicated.
Perform all assignments professionally.
Desired Qualifications
A bachelor’s degree is preferred.
Clinical experience in at least one of these areas is preferred: behavioral health, transplant, neonatal care, or oncology.
Previous managed-care experience is a plus.
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Accepting RN Candidates that reside in North Carolina and Florida Only.
Overview
The Case Manager will be responsible for applying the six essential activities of case management which include assessment, planning, implementation, coordination, monitoring and evaluation with the core components through the administration of quality improvement functions (process, relationships, health care management, community resources and support, service delivery and psychosocial intervention).
Qualifications
Registered Nurse (RN) with active, current, unrestricted license in a Nurse Licensure Compact (NLC) state required. Bachelor’s degree preferred.
Case Management Certification (CCM) required. Candidates without CCM certification are required to obtain it within three (3) years of commencing employment.
Three (3) years of clinical RN experience in a med/surg or ambulatory care setting required. Clinical experience in at least one of the following areas preferred: Behavior Health, Transplant, Neo-Natal or Oncology.
Previous experience in managed care a plus.
Clinical knowledge of the health or social work needs for the population served.
Ability to identify barriers to a successful care management path.
Ability to interact effectively with physicians and other members of the health care team.
Excellent problem-solving abilities, coupled with solid time management skills.
Excellent written, verbal and interpersonal communication skills.
Transferable knowledge, skill and ability to complete job duties independently and proficiently. Flexibility in work schedules and assignments.
Proven examples of displaying Nova’s Core 4: Act with Passion, Work Together, Be Accountable, Build Trust.
Essential Accountabilities
Assess the patient’s broad spectrum of immediate and long-term needs through evaluation of the patient’s social and medical history.
Develop a plan of care based upon the patient and providers of care clinical assessments, considering physical and psychosocial needs, the benefit plan and cost benefit analysis factors which impact the patient’s optimal recovery.
Continuously evaluate the plan of care within the scope of case management practice based on the changing needs of the patient and monitor the quality of care and effectiveness of care being provided for all involved members of the inter disciplinary team.
Ensure compliance with regulatory and privacy standards, prompt payment/reimbursement and appeal process as indicated; coordinate the decision and documentation process; maintain a current and accurate database.
Establish professional working relationships with all members of the interdisciplinary team and communicate case objectives to the appropriate involved parties.
Act as a patient advocate understanding and identifying potential for complications, understanding methods for assessing the current and future physical and psychosocial characteristics of illnesses.
Read, understand and apply principals of the American with Disabilities Act and understand federal legislation affecting individuals with disabilities.
Be knowledgeable of assistive and adaptive equipment.
Establish available support systems and be versed in methods of researching and interviewing community resources to assist the patient in achieving maximum psychological, social and physical recovery.
Effectively communicate to the patient the available services and resources applicable to the patient’s immediate and future needs. Assist the patient in obtaining these services.
Identify cases that would benefit from alternative care through assessment and evaluation of the patient’s needs, as well as available resources.
Work closely with the payor, providers and all involved team members in evaluating the quality and cost effectiveness of services. Negotiate cost discounts when appropriate.
Identify cases that would benefit from alternative levels of care and resources (i.e. rehabilitation facilities and home health care providers). Implement alternatives to existing care, considering quality of care and the patient’s current and ongoing needs.
Understand case management concepts such as roles, philosophies, principles, liability and confidentiality issues. Apply these concepts in developing appropriate plan of care and goals based on the needs of the patient.
Be knowledgeable in applying problem solving techniques to the case management process. Analyze and evaluate outcomes and implement alternatives when appropriate.
Document the patient’s plan of care in a timely manner.
Maintain professional status within the community through membership in professional organizations and/or participation in continuing education.
Participate in Nova’s training and education committees as assigned. Provide input into support staff orientation and training as it relates to the Case Manager’s role.
Provide support, guidance, and direction to support staff as indicated.
Perform all assignments in a professional manner.
Be knowledgeable of the scope of practice of their multi-state licensure and practice accordingly.
Immigration or work visa sponsorship will not be provided for this position
Hiring Compensation Range: $35.50 - $38.00 hourly
Compensation may vary based on factors including but not limited to skills, education, location and experience.
In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.
As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click herefor additional EEO/AAP or Reasonable Accommodation information.
Current Associates must apply internally via the Job Hub.