Care Ally, RN Case Manager

Curana Health, Inc.•Des Moines, IA

4d•Hybrid

About The Position

The Care Ally, Case Manager is a key member of the interdisciplinary care team (ICT), using a collaborative process of assessment, planning, implementation, coordination, monitoring, and evaluation to meet members’ health and social needs. The role acts as a liaison among members, their responsible parties and/or powers of attorney (RP/POAs), Advance Plan Provider/PCP, and Align Senior Care stakeholders. The position reports to the Supervisor of Case Management. The role supports members through health assessments, care planning, education, appointment and benefit assistance, and ongoing follow-up. It coordinates with clinical and internal teams to address member needs, resolve service issues, and facilitate care across senior living communities and other care settings. This is a hybrid role. Candidates must be able to manage field visits independently and have reliable transportation. Travel to assigned facilities averages 2 to 3 days per week, with the remaining time spent working from a home office.

Requirements

One year of clinical practice experience in at least one of these areas: case management, home health, critical care, medical/surgical, discharge planning, or concurrent review.
Proficiency with basic Microsoft Office applications, including Word, Excel, and Outlook, and 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 2 to 3 days per week.
Must have either an active, unrestricted RN or LPN license in the state where job duties are performed, or a Bachelor of Social Work (BSW).

Nice To Haves

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

Responsibilities

Execute strategies and goals set by the Align Senior Care Board of Directors, Senior Leadership Team, and Executive Director for managing and improving the overall member experience.
Contact plan members to conduct comprehensive health assessments, develop care plans, and participate in facility interdisciplinary care team meetings.
Educate members, families, and caregivers about disease status and treatment, plan benefits, community resources, and available resource 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 interventions, including making and verifying appointments and supporting medication and care compliance.
Serve as front-line support and a connection point among members, their RP/POAs, communities, care teams, and Align Senior Care departments.
Engage members and RP/POAs in person or by phone to explain and assist with using plan benefits, check on 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 on non-urgent health or clinical questions.
Work with internal departments to resolve 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, order durable medical equipment, and assist with using supplemental benefits.
Monitor and, when needed, facilitate care team meetings involving facility teams, members, responsible parties, and APP/clinical teams.
Document care team meetings and transmit 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 hospitals or other levels of care.