Care Ally, RN Case Manager

Curana Health, Inc.•Deridder, LA

4d•Hybrid

About The Position

The Care Ally, Case Manager is a key member of the interdisciplinary care team (ICT). The role uses a collaborative process of assessment, planning, implementation, coordination, monitoring, and evaluation to identify options and services that meet members’ health and social needs. The Care Ally acts as a liaison among members, their Responsible Parties and/or Power of Attorneys (RP/POAs), Advance Plan Provider/PCP, and key Align Senior Care stakeholders. This position reports to the Supervisor of Case Management. The Care Ally contacts plan members to assess their health, develop care plans, provide education, coordinate services, and monitor progress. The role also supports members and RP/POAs with benefits, appointments, provider access, health updates, grievances, and other needs. Work 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, schedule field visits, complete documentation, meet deadlines, and follow up consistently.

Requirements

One year of clinical practice experience in at least one of the following 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.
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 willingness to travel to assigned facilities an average of 2 to 3 days per week.

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 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 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 conducting medication and care compliance initiatives.
Serve as front-line support for members and RP/POAs, connecting them 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 non-urgent health or clinical questions with the care team.
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 support 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 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.