Care Ally, RN Case Manager

Curana Health, Inc.•Ville Platte, 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 serves 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 Care Ally supports members in senior living and skilled nursing settings through health assessments, care planning, education, follow-up, appointment coordination, benefit navigation, and communication with caregivers and care teams. The role is hybrid: employees travel to assigned facilities an average of two to three days per week and spend the remaining time 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; 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.
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 treatment for members.
Follow up with members as scheduled to assess progress toward goals.
Work with members and/or 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 initiatives.
Act as front-line support for members and their RP/POAs, connecting them with their communities, care teams, and Align Senior Care 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 to 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 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, durable medical equipment orders, and use of supplemental benefits.
Monitor and, when needed, facilitate care team meetings involving facility staff, members, responsible parties, and the APP/clinical team.
Ensure care team meeting documentation is completed and transmitted 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 information to help identify member transitions to a hospital or other levels of care.