RN Care Manager (DSNP)

Marshfield ClinicMarshfield, WI
33dRemote

About The Position

JOB SUMMARY The Care Manager-RN is a Registered Nurse (RN) who functions as an integral member of the Case Management Team of Security Health Plan. The RN is responsible for the assessment, coordination, planning, and implementation of case management services. S/he is also responsible for carrying out the management of specific, individual medical episodes identified through utilization review, disease management, and quality assurance functions. This individual ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: Graduate of an accredited school of nursing. Preferred/Optional: Bachelor's degree in nursing preferred. EXPERIENCE Minimum Required: Five years' clinical experience in home health, nursing home, hospital, community outreach care, case management, utilization management, and/or discharge planning. Experience with keyboard, computer, and general office equipment. Preferred/Optional: Experience in quality assurance/improvement. Knowledge of insurance, BadgerCare/Medicaid, and Medicare requirements. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: Current State of Wisconsin Registered Nurse License or Nurse Compact License. Basic Life Support (BLS) certification awarded by the American Heart Association (AHA) within three months of hire. Valid driver's license required with an acceptable record. Preferred/Optional: Utilization Review and/or case management certification preferred Basic Life Support (BLS) certification awarded by the American Heart Association (AHA) at time of hire. Travel is a requirement for face to face interaction with the DSNP members/families, care conferences, etc. Travel is not daily. All DSNP RN's work from home. Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System's Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program . Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

Requirements

  • Graduate of an accredited school of nursing.
  • Five years' clinical experience in home health, nursing home, hospital, community outreach care, case management, utilization management, and/or discharge planning.
  • Experience with keyboard, computer, and general office equipment.
  • Current State of Wisconsin Registered Nurse License or Nurse Compact License.
  • Basic Life Support (BLS) certification awarded by the American Heart Association (AHA) within three months of hire.
  • Valid driver's license required with an acceptable record.
  • Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid.

Nice To Haves

  • Bachelor's degree in nursing preferred.
  • Experience in quality assurance/improvement.
  • Knowledge of insurance, BadgerCare/Medicaid, and Medicare requirements.
  • Utilization Review and/or case management certification preferred
  • Basic Life Support (BLS) certification awarded by the American Heart Association (AHA) at time of hire.

Responsibilities

  • assessment
  • coordination
  • planning
  • implementation of case management services
  • management of specific, individual medical episodes identified through utilization review, disease management, and quality assurance functions
  • evaluating the effectiveness of alternative care services
  • ensuring cost effective, quality care is maintained

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

No Education Listed

Number of Employees

5,001-10,000 employees

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