RN Case Manager - CareVio Outpatient

Job Details

RN Case Manager - CareVio - Outpatient

Hybrid position 8-4:30 with 1 evening requirement

Wilmington, DE

ChristianaCare CareVio is hiring an RN Case Manager. The Case Manager is responsible for the coordination of care for a complex patient population with medical and social determinants of health needs.  The Case Manager works to improve outcomes and reduce preventable readmissions.  The Case Manager will coordinate the utilization of healthcare resources, including planning transitions, facilitating the achievement of quality, clinical, financial, and member satisfaction goals.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Perform ongoing telephonic case management activitiesofassessment,problem identification, planning, implementation, coordination, monitoring,and evaluationofcase managedmembers.
• Collaborates with patients,caregivers,and membersofthemulti-disciplinarycare teamtodevelopamember centered planofcaretomeet identified member care goals and outcomes.
• Develop,implement,evaluate, and revise case management care plans accordingtocase management eligibility criteria, contractual guidelines andmembersphysicalandpsychological needsthroughoutthe continuumofcare.
• Identifies system issues that serve asbarriersto care. Participatesindevelopmentand implementationofstrategiestoremove barriers and promoteresolution through coordinationof aproblem-solvingprocess.
• Promote member wellness and autonomythroughadvocacy,communication, education,andidentificationand referraltocommunity resourcesorothercasemanagementprograms suchasdisease managementprograms.
• Identify appropriate providers andfacilities throughthecontinuumofservices and ensure that availableresourcesarebeing usedtimelyandcost-effectivemanner.
• Collaboratewith transitional,embedded, andinpatientcasemanagersin thedischarge andtransitional careprocess,obtaining and/or coordinatingappropriateresources for members throughoutthecontinuumofcare.
• Stratifies and/orvalidatesmember levelofrisk duringeachtransitionprocess and interaction with themember.
• Collaborateswithhealthcareprovidersinsettings notlimited to the PCPoffice, hospital,skilled nursingfacilityor home care agencies to assistmembersin coordinating safe

• transitions andenhancedcommunicationofthe treatment plan toallmembersofthemultidisciplinarycare team
• Makes referralstothepharmacist,social worker, orcommunity outreach teamasneededtoprovide holistic approachofcare.
• Manages assigned caseload in anefficientandeffectivemannerutilizing time management skillstofacilitatethe totalworkprocessdirectlymonitoring assigned members.
• Demonstratesknowledgeofutilizationmanagementandcarecoordinationprocessesandcurrentstandardsofcareas afoundationfor transition planning, complexcasemanagementanddisease managementactivities
• Confers with Medical Directors regardingcomplexcases requiring physician input regarding thetreatmentplan orphysiciantotreatingphysiciancollaboration.
• Adheres to organizationalanddepartmentalpolicies and proceduresandcredentialed compliance.
• Performs assignedworksafely,adheringtoestablisheddepartmentalsafety rules andpractices. Reportstosupervisor,in atimely manner,anyunsafe activities, conditions,hazards,orsafetyviolationsthatmaycauseinjurytooneself,otheremployees,membersandvisitors.
• Performsallother related dutiesasassignedbyManager/Director

ChristianaCare Offers:

• Full Medical, Dental, Vision, Life Insurance, etc.
• Two retirement planning offerings, including 403(b) with company contributions.
• Generous paid time off with annual roll-over and opportunities to cash out.
• 12 week paid parental leave.
• Tuition assistance
• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through Care@Work, retirement planning services, financial mentor, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

Education & Special Requirements:   

• Registered Nurse with BSN required.
• ActiveDE RNLicensure or Compact Licensure,ingoodstanding
• Ability to obtain a non-compact state RN Licensure as needed
• Active Basic Life Support (BLS) certification
• RelevantexperienceinUtilizationManagement orCaseManagement required.
• CaseManagementCertificationrequiredthroughtheCommission for Case Management (CCM) or American Case Management Associationwithin18-monthsof eligibility.
• Advanced Certification recommended.

PHYSICAL DEMANDS:

• Ability to ambulate within an office setting (walking, stairs, etc.)
• Occasional sitting, standing, and lifting loads of 5-10 pounds.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program.  To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/