Care Ally, RN Case Manager

Curana Health, Inc.•Opelousas, LA

4d•Hybrid

About The Position

The Care Ally, Case Manager is a key member of the interdisciplinary care team (ICT), using a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate services that meet members’ health and social needs. The role acts as a liaison among members, their Responsible Parties and/or Power of Attorneys (RP/POAs), Advance Plan Providers/PCPs, and Align Senior Care stakeholders. The position reports to the Supervisor of Case Management. The Care Ally supports member experience and care coordination through assessments, care planning, health coaching, follow-up, and connections to providers and community resources. The position also helps resolve member issues, coordinates with the care team, and maintains care-related documentation. This is a hybrid role: candidates travel to assigned facilities an average of two to three days per week and work the remaining time 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, discharge planning, or concurrent review.
Basic computer proficiency in Microsoft Word, Excel, and Outlook, including 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 ability to travel to assigned facilities an average of two to three days per week.
Must have either 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 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 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 resource options.
Collaborate with interdisciplinary care team members and medical directors to facilitate appropriate treatment.
Follow up with members as scheduled to assess progress toward goals.
Communicate with members and caregivers to develop health goals and identify interventions to achieve them.
Provide patient-centered interventions, including making and verifying appointments and conducting medication and care compliance initiatives.
Serve as front-line support for members and their RP/POAs, connecting them with their communities, care teams, and internal departments.
Engage members and RP/POAs in person or by phone to provide education and help them use Align Senior Care benefits, including checking on specialist appointments, connecting members to supplemental benefits and providers, identifying immediate needs, and answering 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 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 facilitate use of supplemental 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 hospitals or other levels of care.