Care Ally, RN Case Manager

Curana Health, Inc.•Thibodaux, LA

17d•Hybrid

About The Position

The Care Ally, Case Manager is a key member of the interdisciplinary care team (ICT) and uses a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options and services that address members’ health and social needs. The role serves as a liaison among members, their responsible parties and/or powers of attorney (RP/POAs), Advance Plan Providers/PCPs, and Align Senior Care stakeholders. The position reports to the Supervisor of Case Management. The role supports members through health assessments, individualized care planning, education, appointment and benefit coordination, follow-up, and communication with caregivers and care teams. It also helps resolve member concerns and coordinate services across senior living communities, providers, and internal departments. This is a hybrid role. Employees independently manage and schedule field visits, with travel to assigned facilities an average of two to three days per week and the remaining time working from a home office. Reliable transportation is required.

Requirements

At least one year of clinical practice experience in case management, home health, critical care, medical/surgical care, discharge planning, or concurrent review.
Proficiency with basic Microsoft Office applications, including Word, Excel, and Outlook, and the ability to navigate multiple systems and perform keyboarding.
Ability to work autonomously in a hybrid role, independently manage and schedule field visits, complete documentation, meet deadlines, and follow up consistently.
Reliable transportation and willingness to travel to assigned facilities an average of two to three days per week.
Meet one of the following credential requirements: an active, unrestricted RN or LPN license in the state where job duties are performed, or a bachelor’s degree in social work (BSW).

Nice To Haves

Case management certification.
Long-term care or nursing facility experience.
Master of Social Work (MSW) degree and social-work licensure.

Responsibilities

Execute strategies and goals established by the Align Senior Care Board of Directors, Senior Leadership Team, and Executive Director to manage and improve the overall member experience.
Contact plan members to conduct comprehensive health assessments, develop plans of care, and participate in facility interdisciplinary care team meetings.
Educate members, families, and caregivers about disease status and treatment, plan benefits, community resources, and available options.
Collaborate with interdisciplinary care team members and medical directors to facilitate appropriate member treatment.
Follow up with members as scheduled to assess progress toward goals.
Work with members and caregivers to develop health goals and identify interventions to achieve them.
Provide patient-centered support, including making and verifying appointments and carrying out medication and care compliance initiatives.
Serve as front-line support for members and RP/POAs, connecting them with their communities, care teams, and Align Senior Care departments.
Engage members and RP/POAs in person or by phone to explain and help use plan benefits, check on upcoming specialist appointments, connect members with supplemental benefits and providers, identify immediate needs, and answer questions.
Communicate member health updates from the care team to RP/POAs.
Coordinate with the care team regarding non-urgent health or clinical questions.
Work with internal departments to address member grievances and utilization management or billing issues.
Update member and RP/POA contact information, including address, email, and phone number changes.
Support the Account Manager in identifying and securing contracts with preferred providers.
Help members, RP/POAs, and partner communities locate in-network providers and schedule or facilitate appointments.
At the request of a member or APP, coordinate home health and therapy visits, durable medical equipment orders, and use of supplemental member benefits.
Monitor and, when needed, facilitate care team meetings involving facility teams, members, responsible parties, and the APP/clinical team.
Document care team meetings and transmit the documentation to the plan.
Monitor care plan updates, facilitate APP and PCP input, and distribute care plans to care team members as needed.
Monitor midnight reports and community census to help identify member transitions to a hospital or another level of care.