RN Care Ally

Duly Health and Care • Bloomingdale, IL

1d • $67,000 - $101,000

About The Position

The RN Case Manager - Care Ally works collaboratively with physicians, patients, and families to promote quality outcomes for patients with complex medical needs. The role supports efficient utilization of health care services by identifying chronic or catastrophic cases through case management processes and initiating intensive case management according to program guidelines.

The Case Manager manages patients across health care settings to help ensure the appropriate level of care, prevent inpatient readmissions, and address patients’ medical, environmental, and psychosocial needs throughout the continuum of care. The Nurse Case Manager advocates for patients by coordinating and communicating with the health care team and families about care planning and recovery goals. The role also assesses and coordinates available resources and helps maximize patients’ use of health care benefits.

Requirements

• Active Registered Nurse license in good standing in the State of Illinois.
• Current CPR certification (BLS), which must be maintained.
• Associate’s degree in nursing.
• 2–4 years of experience working as a Registered Nurse in a primary care or hospital setting.

Nice To Haves

• Certification in Case Management.
• Bachelor’s degree in nursing.
• Previous experience working in case management.

Responsibilities

• Analyze data from predictive modeling tools to identify patients eligible for the Case Management Program.
• Enroll and manage a caseload of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements.
• Develop individualized case management plans with prioritized goals and appropriate interventions in compliance with risk stratification requirements.
• Complete documentation, member communications, and case closures according to policies and procedures.
• Coordinate health care services with appropriate physicians and health care providers.
• Manage and provide a comprehensive summary and log of active Case Management cases as required by the UM/QA Committee and/or Health Plan.
• Act as a resource for Utilization Management staff, physicians, office staff, and patients.
• Assist with evaluating and amending Case Management policies and procedures.
• Attend continuing education sessions and training related to job functions as required.
• Perform additional duties and tasks as assigned.

Benefits

• Comprehensive medical, dental, and vision benefits, including healthcare navigation assistance.
• Access to a mental health benefit at no cost.
• Employer-provided life and disability insurance.
• $5,250 tuition reimbursement per year.
• Immediate 401(k) match.
• 40 hours of paid volunteer time off.
• Up to 12 weeks of parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members, subject to eligibility requirements.
• Additional compensation may be available through shift differentials, bonuses, and other incentives.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree