Care Manager RN Hybrid

Job Title : Care Manager RN

Location : New Castle County Delaware

Hybrid Role

Benefits : Health Vision Dental 401K mileage reimbursement

Summary :

The Care Manager will mostly with few exceptions be going into homes to visit homebased members (occasionally to motels if the member is unhoused or to hospitals but these will be sporadic visits). The Care Manager will assist members in overcoming obstacles to optimal care which includes assessing planning coordinating and implementing appropriate care.

Responsibilities

Travel to members homes (occasionally a hospital or motel and very rarely a longterm care facility or nursing home) and other communitybased settings to complete facetoface assessments with subsequent telephonic contact with the member in accordance with state and national guidelines policies procedures and protocols.

Assess plan coordinate implement and evaluate care for eligible members with chronic and complex health care social service and custodial needs in a nursing facility or home and communitybased care setting.

Coordinate care across the continuum of services and assisting members with physical behavioral long term services and supports (LTSS) social and psychosocial needs in the safest least restrictive way possible while considering the most costeffective way to address those needs.

Facilitate authorization coordination continuity and appropriateness of care and services in community or HCBS.

Facilitate transitions to alternate care settings such as hospital to home nursing facility to community setting using an integrated care team to address the members specific needs.

Educate members or caregivers regarding health care needs available benefits resources and services including available options for long term care community or facilitybased service delivery.

Provide education resources and assistance to help members achieve goals as outlined in their plan of care and to overcome obstacles to achieving optimal care in the least restrictive environment.

Develop a plan of care in conjunction with members or caregivers to identify services to meet the members specific needs and goals.

Identify resources needed for a fully integrated care coordination approach including facilitating referrals to special programs such as Disease / Chronic Condition Management Behavioral Health and Complex Case Management.

Collaborate with the members health care and service delivery team including the DSHP Plus LTSS Member Advocate ICT and discharge planners to coordinate the care needs and community resources for the member to maintain the member in the least restrictive safe

environment possible. Assist members in developing implementing and amending a backup plan for gaps in provider coverage.

Ensure approved support services are being provided as outlined in the plan of care. Evaluate the effectiveness of the service plan and make appropriate revisions as needed in accordance with per policy & procedures and state contractual requirements.

Assist members in overcoming obstacles to optimal care through connection with community resources including communicating with providers and formulating an appropriate action plan.

Document all case management services and intervention in the electronic health record. Adhere to all company State and Federal requirements related to privacy practices HIPAA and quality performance standards.

Perform other duties as assigned / requested.

Qualifications :

Required Qualifications :

Registered Nurse in the state of DE with case management experience

Experience completing Assessments developing Service Plans and Care Plans

Experience collaborating with PCPs Occupational Therapists Behavioral Health and Providers

Experience with ordering DME Equipment

Experience educating and providing resources for the members Social Determinants. They must have experience with discharging members from a Facility setting.

Working flexible hours to meet members needs

Proficiency in PCbased word processing and database documentation (Word Excel Internet Outlook)

Reliable transportation daily to be able to travel within assigned territory

Ability to meet regulatory deadlines.

Has a dedicated home work space used only for business purposes and is able to comply with all telecommuter policies.

Experience in geriatric special needs behavioral health home health

Understanding of the importance of cultural competency in addressing targeted populations.

Experience with electronic documentation system(s)

Experience with cost neutrality and budgeting

Must be willing to travel throughout the state (may only need to travel 23 times a week depending on schedule)

Must be able to communicate clearly to members will be tasked with conducting assessments with members over the phone

Must be very organized

Preferred Qualifications :

Certified Case Manager (CCM)

Licensed Bachelors Social Worker (LBSW)

Licensed Masters Social Worker (LMSW)

Licensed Clinical Social Worker (LCSW)

Experience working with HIV / AIDS population

Experience working with behavioral health population

Experience working with developmental disabilities population

Medicare and Medicaid experience.

Note : This is for US citizens only. Candidates MUST be licensed in the state of Delaware and MUST be located in New Castle County.

Additional Information :

Thanks & Regards

Praveen Kumar

Sr. Recruiter

Zillion Technologies Inc

Email : praveen(at)zilliontechnologies(dot)com

Phone : Remote Work :

Employment Type :

Fulltime

Key Skills

Corporate Paralegal,Car Driving,Design Engineering,Electrical Controls,Consultancy

Experience : years

Vacancy : 1