Care Ally, RN Case Manager

Curana Health, Inc.•Waterloo, 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 to assess, plan, implement, coordinate, monitor, and evaluate services that address members’ health and social needs. The role serves as a liaison among members, their Responsible Parties and/or Power of Attorneys (RP/POAs), Advance Plan Provider/PCP, and Align Senior Care stakeholders, and reports to the Supervisor of Case Management. The position supports member experience and care coordination through health assessments, care planning, education, follow-up, appointment and medication compliance assistance, and coordination with clinical teams and community resources. It also provides front-line support to members and RP/POAs, addresses service and administrative issues, helps members access in-network providers and benefits, and supports communication and documentation across the care team. The role is hybrid: candidates travel to assigned facilities an average of 2 to 3 days per week and spend the remaining time working from a home office. Candidates must be able to work autonomously, manage field visits and documentation, meet deadlines, and follow up consistently. 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.
Must have an active, unrestricted RN or LPN license in the state where job duties are performed, or a bachelor’s degree in social work (BSW).
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 2 to 3 days per week.
Must be authorized to work without visa sponsorship; the company is unable to provide sponsorship for a visa at this time.

Nice To Haves

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

Responsibilities

Execute strategies and goals established by the Align Senior Care Board of Directors, Senior Leadership Team, and Executive Director for managing and improving 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 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/or 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 members with their communities, care teams, and Align Senior Care departments.
Engage members and RP/POAs in person or by phone to explain and assist with use of 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 on non-urgent health or clinical questions.
Work with internal departments to resolve member grievances and utilization management and 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 assist with use of supplemental benefits.
Monitor and, if needed, facilitate care team meetings with 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 the hospital or other levels of care.