RN Case Manager (Northeast Indiana)

CareBridge-posted 4 months ago
Full-time • Mid Level
Fort Wayne, IN
251-500 employees
Ambulatory Health Care Services
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The RN Case Manager is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to non-RN clinicians participating in the member's case, as required by the IN PathWays for Aging program; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement.

  • Perform telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long term services and supports.
  • Identify members for high risk complications and coordinate care in conjunction with the member and the health care team.
  • Manage members with chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of health benefits.
  • Obtain a thorough and accurate member history to develop an individual care plan.
  • Establish short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identify members that would benefit from an alternative level of care or other waiver programs.
  • Develop the care plan for services for the member and ensure the member's access to those services.
  • Assist with the implementation of member care plans by facilitating authorizations/referrals for utilization of services, as appropriate.
  • Interface with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on the development of care management treatment plans.
  • Assist in problem solving with providers, claims or service issues.
  • Direct and/or supervise the work of any LPN/LVN, LSW, LCSW, LMSW, and other licensed professionals in coordinating services for the member.
  • Requires an RN and minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role.
  • Current, unrestricted RN license in applicable state(s) required.
  • MA/MS in Health/Nursing preferred.
  • Experience working with older adults in care management, provider or other capacity, highly preferred.
  • Experience managing a community and/or facility-based care management case load, highly preferred.
  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Short and long term disability benefits
  • 401(k) + match
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources
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