Care Ally, RN Case Manager

Curana Health, Inc.•New Orleans, 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 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 member experience and care coordination through health assessments, care planning, education, follow-up, appointment and medication-compliance support, and coordination with the care team. It also helps members and their representatives access benefits and providers, resolve service and billing issues, maintain contact information, coordinate care transitions, and ensure care team meeting and care plan documentation is shared with the Plan. This is a hybrid role. The employee must be able to work autonomously, manage and schedule field visits, and travel to assigned facilities an average of two to three days per week; the remaining time is spent working from a home office. Reliable transportation is required.

Requirements

One year of clinical practice experience in at least one of the following: case management, home health, critical care, medical/surgical, discharge planning, or concurrent review.
Proficiency with basic Microsoft Office applications, including Word, Excel, and Outlook; 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 comfort traveling to assigned facilities an average of two to three days per week.
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) and social-work licensure.

Responsibilities

Execute strategies and goals set 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 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.
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 carrying out medication and care compliance initiatives.
Act as front-line support for members and their RP/POAs, connecting members with their communities, care teams, and internal departments.
Engage members and RP/POAs in person or by phone to provide education and assistance with 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 a member’s or APP’s request, coordinate home health and therapy visits, order durable medical equipment, and support 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 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 other level of care.