PT - Case Manager-RN, Mid

Acentra Health, LLC•UNAVAILABLE, UNAVAILABLE

5d•Remote

About The Position

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision-making, and drive better health outcomes. We value professionals who are curious about new technologies and motivated to use innovative tools to increase efficiency, quality, and impact in their roles. Acentra seeks a Part-Time Case Manager - RN, Mid to join our growing team. Job Summary: The Case Manager, RN, will evaluate beneficiaries' needs, develop individualized care plans, and coordinates healthcare team members to ensure optimal client outcomes while adhering to payer requirements. They also facilitate integrated case and disease management activities based on CMSA principles, aiming to stabilize beneficiaries' health and avoid long-term care placement.

Requirements

Current, unrestricted Registered Nurse (RN) license in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline.
3 - 5 years RN clinical experience required.

Nice To Haves

BSN and CCM preferred
Proficiency in using Microsoft Word, Excel, and other applications in the Microsoft Office suite.
Excellent written and verbal communication skills.
Ability to work effectively in a team environment.
Maintain a high level of confidentiality.
Good problem-solving skills.
Ability to maintain metrics and goals within the department.
Work telephonically, and with computer systems.
Assist members and conduct outreach to members without prior engagement.
Flexibility and strong organizational skills.
Strong understanding of cultural competency when working with the population.
Experience with Medicaid, Medicare or Commercial health plans.
Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making.
Demonstrated initiative and judgment in the performance of job responsibilities.
Maintain professionalism, flexibility, and dependability under pressure.
Strong communication (written/verbal), interpersonal, organizational, time management and communication skills with a strong focus on customer service, including building and maintaining relationships with internal/external customers and facilitating meetings.
Ability to work independently and as part of a team.
Ability to research/identify and apply appropriate standards of care.
Interest in continuous learning and a commitment to staying informed on regulatory changes

Responsibilities

Assess, plan, implement, monitor, and evaluate options and services to affect an appropriate, individualized plan with the beneficiary across the continuum of care.
Utilize clinical knowledge and competence, communication skills, problem-solving, and conflict resolution to ensure optimal beneficiary outcomes with consideration to client requirements effectively.
Develop beneficiary-centered care plans.
Demonstrate shared accountability between beneficiaries, caregivers, and providers.
Work collaboratively with the beneficiary, provider, and Health Plan Care team members to coordinate care.
Address identified gaps in care or compliance.
Maintain strict standards for client confidentiality and client-related information.
Comply with all organizational, state, and federal regulations and policies on confidentiality.
Manage caseload to ensure all required documentation and entry of assessment results into the web-based database are completed accurately and timely, following regulatory requirements and company policies and procedures.
Maintain open communication with all appropriate parties.
Pursue ongoing education, certification, and self-development to remain current with case management standards.
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules