Care Ally, RN Case Manager

Curana Health, Inc.•Cedar Rapids, IA

4d•Hybrid

About The Position

The Care Ally, Case Manager is a member of the interdisciplinary care team (ICT) who uses a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate services needed to 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 member experience and care coordination by conducting health assessments, developing care plans, educating members and caregivers, following up on care goals, facilitating treatment and appointments, and connecting members with benefits, providers, and community resources. The role also helps resolve member concerns and coordinates information among members, caregivers, communities, and internal care teams. This is a hybrid role requiring independent scheduling and management of field visits. Candidates must have reliable transportation and be comfortable traveling to assigned facilities an average of two to three days per week, with the remaining time working from a home office.

Requirements

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.
At least one year of clinical practice experience in case management, home health, critical care, medical/surgical, discharge planning, or concurrent review.
Proficiency with basic Microsoft Office applications, including Word, Excel, and Outlook, and ability to navigate multiple systems and perform keyboarding.
Meet one of the following professional qualification paths: 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 established 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/or 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.
Serve 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 plan benefits, appointments, supplemental benefits, providers, immediate needs, and 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 address 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 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.