Case Manager

Kyyba•Detroit, MI

1d•Remote

About The Position

Kyyba is hiring a fully remote Case Manager for an out-of-state position. The Case Manager leads coordination of a regionally aligned, multidisciplinary team to provide holistic care to members through telephone and/or digital channels. The role uses the case management process to assess member needs, develop and manage individualized care plans, coordinate services and transitions, and support members in improving their health outcomes. The multidisciplinary team includes medical and behavioral health social workers, registered dietitians, pharmacists, clinical support staff, and medical directors. The Case Manager assesses members’ health, psychosocial needs, cultural preferences, and support systems; engages members and caregivers in care planning; identifies barriers and gaps in care; arranges appropriate resources; and coordinates with providers, community agencies, family, and other support systems. The role also provides education, advocates for members, monitors care-plan progress, documents interactions, and supports transitions between facilities and home. The employee must adhere to professional protocols and quality and production goals, and continue professional development by completing relevant education and maintaining Certified Case Manager (CCM) status. Kyyba describes a work culture based on value, passion, excellence, empowerment, and happiness, and states that it supports employee well-being through benefits, career development, incentives, resources, flexibility, and a balanced compensation structure. The position is fully remote, with no onsite work required.

Requirements

Nursing diploma or associate degree in nursing required.
Three years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
One year of case management experience in a managed care setting required.
Health plan case management experience.
Ability to think critically, make decisions, and solve problems affecting member outcomes.
Empathetic, supportive approach and good listening skills.
Intermediate computer knowledge, typing capability, and proficiency in Microsoft programs such as Excel, OneNote, Outlook, Teams, and Word.
Proficiency in motivational interviewing skills.
Demonstrated time-management skills.
Organizational skills and ability to manage multiple systems and tools while interacting with a member.
Ability to work as part of a team and independently.
Excellent written and verbal interpersonal and communication skills.

Nice To Haves

Bachelor’s degree in nursing strongly preferred.
Experience managing patients by telephone and through digital channels, including mobile applications and messaging, preferred.
Current, active, unrestricted Multistate Compact Registered Nurse license preferred.
Certification in Case Management (CCM) preferred.
Certification in Chronic Care Professional (CCP) preferred.

Responsibilities

Lead coordination of a regionally aligned, multidisciplinary team providing holistic care to members by telephone and/or digital channels.
Use the case management process to assess, develop, implement, monitor, and evaluate care plans across the care continuum.
Assess members’ health, psychosocial needs, cultural preferences, and support systems.
Engage members and/or caregivers to develop individualized plans of care, address barriers, identify gaps in care, and promote improved health outcomes.
Arrange resources to meet identified needs, including community resources, mental health and substance abuse services, financial support services, and disease-specific services.
Coordinate care delivery and support among members’ providers, community-based agencies, families, and other support systems.
Advocate for members and promote self-advocacy.
Educate members and caregivers about health literacy, self-management skills, medication plans, and nutrition.
Monitor and evaluate care-plan effectiveness and adherence, assess progress toward goals, and adjust and reevaluate the plan as necessary.
Accurately document interactions that support member management.
Prepare members and/or caregivers for discharge from a facility to home or transfer to another healthcare facility to support continuity of care.
Educate members and/or caregivers about post-transition care and follow-up, and summarize what happened during an episode of care.
Secure durable medical equipment and transportation services and communicate arrangements to members and/or caregivers and key individuals at the receiving facility or home care agency.
Follow professional standards, protocols, rules, and guidelines while meeting quality and production goals.
Complete relevant continuing education and maintain Certified Case Manager (CCM) status.