What are the responsibilities and job description for the Case Management Nurse position at Medasource?
Job Description:
- Start Date: ASAP
- Location: Fully Remote- Indiana
- Hours: 40 hour work weeks
- RN license required
Essential Functions:
- § Engage the member and their natural support system through strength-based assessments and a trauma-informed care approach using motivation interviewing to complete health and psychosocial assessments through a health equity lens unique to the needs of each member that identify the cultural, linguistic, social and environmental factors/determinants that shape health and improve health disparities and access to public and community health frameworks
- § Facilitate regularly scheduled inter-disciplinary care team (ICT) meetings to meet the needs of the member
- § Engage with the member to establish an effective, professional relationship via telephonic or electronic communication
- § Develop a person-centered individualized care plan (ICP) in collaboration with the ICT, based on member’s desires, needs and preferences
- § Identify and manage barriers to achievement of care plan goals
- § Identify and implement effective interventions based on clinical standards and best practices
- § Assist with empowering the member to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination and case management
- § Facilitate coordination, communication and collaboration with the member the ICT in order to achieve goals and maximize positive member outcomes
- § Educate the member/ natural supports about treatment options, community resources, insurance benefits, etc. so that timely and informed decisions can be made
- § Employ ongoing assessment and documentation to evaluate the member’s response to and progress on the ICP
- § Evaluate member satisfaction through open communication and monitoring of concerns or issues
- § Monitors and promotes effective utilization of healthcare resources through clinical variance and benefits management
- § Verify eligibility, previous enrollment history, demographics and current health status of each member
- § Completes psychosocial and behavioral assessments by gathering information from the member, family, provider and other stakeholders
- § Oversee (point of contact) timely psychosocial and behavioral assessments and the care planning and execution of meeting member needs
Education and Experience:
- Nursing degree from an accredited nursing program or Bachelor’s degree in a health care field or equivalent years of relevant work experience is required
- Advanced degree associated with clinical licensure is preferred
- A minimum of three (3) years of experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required
- Three (3) years Medicaid and/or Medicare managed care experience is preferred
Licensure and Certification:
- Current and unrestricted license as a Registered Nurse (RN), Licensed Social Worker (LSW), or Licensed Independent Social Worker (LISW) in the State of Ohio required
- Case Management Certification is highly preferred
