Case Manager (RN) - Outpatient - Primary Care
About The Position
Case Manager (RN) - Outpatient Primary Care (CareVio) M-F - (Hours: Hours: 8:30 am – 4:30 pm; on-call requirement per department schedule) Site/Location: Christiana Care Primary Care Practice, site/location to be determined. Up to 4 days/week on-site is required, dependent on the practice. Case Manager (RN) is responsible for the coordination of care for a complex patient population with medical and social determinants of health needs. The Case Manager works to improve outcomes and reduce preventable readmissions. The Case Manager will coordinate the utilization of healthcare resources, including planning transitions, facilitating the achievement of quality, clinical, financial, and member satisfaction goals.
Requirements
- Registered Nurse with BSN required or relevant experience in Utilization Management or Case Management
- DE RN License or Compact Licensure. Ability to obtain a non-compact state RN Licensure as needed.
- Basic Life Support (BLS) certification required.
Nice To Haves
- Case Management Certification is preferred through the Commission for Case Management (CCM) within 18 months of eligibility.
- Advanced Certification recommended.
Responsibilities
- Perform ongoing telephonic case management activities of assessment, problem identification, planning, implementation, coordination, monitoring, and evaluation of case managed members.
- Collaborates with patients, caregivers, and members of the multi-disciplinary care team to develop a member centered plan of care to meet identified member care goals and outcomes.
- Develop, implement, evaluate, and revise case management care plans according to case management eligibility criteria, contractual guidelines and members physical and psychological needs throughout the continuum of care.
- Identifies system issues that serve as barriers to care.
- Participates in development and implementation of strategies to remove barriers and promote resolution through coordination of a problem-solving process.
- Promote member wellness and autonomy through advocacy, communication, education, and identification and referral to community resources or other case management programs such as disease management programs.
- Identify appropriate providers and facilities through the continuum of services and ensure that available resources are being used in a timely and cost-effective manner.
- Collaborate with transitional, embedded, and inpatient case managers in the discharge and transitional care process, obtaining and/or coordinating appropriate resources for members throughout the continuum of care.
- Stratifies and/or validates member level of risk during each transition process and interaction with the member.
- Collaborate with health care providers in settings not limited to the PCP office, hospital, skilled nursing facility or home care agencies to assist members in coordinating safe transitions and enhanced communication of the treatment plan to all members of the multidisciplinary care team.
Benefits
- ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program.
- To learn more about our benefits for eligible positions visit https://careers.christianacare.org/benefits-compensation/
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
