Care Manager, RN

TPI Global Solutions; Delaware; On-site; USD 56,000 - 86,000; Full time

Job summary

A leading company is seeking a Senior Talent Acquisition Specialist to manage care for members with complex health needs. The role involves face-to-face assessments, care coordination, and collaboration with healthcare teams to ensure optimal service delivery. Candidates should be Registered Nurses with extensive case management experience and a commitment to cultural competency. This position is based in New Castle County, DE, and requires travel within the state.

Qualifications

• 5 years of Intensive Case Management and Discharge Planning experience.
• Experience completing Assessments, developing Service Plans and Care Plans.

Responsibilities

• Travel to members’ homes to complete face-to-face needs assessments.
• Coordinate care across the continuum of services for eligible members.

Skills

Cultural Competency

Organization

Communication

Education

Registered Nurse in the state of DE

Tools

Electronic Documentation System

PC-based Word Processing

Job description

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Senior Talent Acquisition Specialist at TPI Global Solutions

Please see below job details:

Position : Care Manager, RN CW

Location: New Castle County, DE

Duration: 03+ months (Contract to Hire)

• Position is for New Castle County (open to candidates in this county or within proximity)
• Must reside in Delaware
• Face-to-face visits will be required. Must be willing to begin visits on week 1.

Responsibilities:

• Travel to members’ homes, nursing facilities, and other community-based settings to complete face to face needs assessments with subsequent telephonic contact with the member in accordance with state and national guidelines, policies, procedures, and protocols.
• Assess, plan, coordinate, implement and evaluate care for eligible members with chronic and complex health care, social service and custodial needs in a nursing facility or home and community-based care setting.
• Coordinate care across the continuum of services and assisting members physical, behavioral, long-term services and supports (LTSS), social, and psychosocial needs in the safest, least restrictive way possible while considering the most cost-effective way to address those needs.
• Facilitate authorization, coordination, continuity and appropriateness of care and services in community or HCBS.
• Facilitate transitions to alternate care settings such as hospital to home, nursing facility to community setting using an integrated care team to address the member’s specific needs.
• Educate members or caregivers regarding health care needs, available benefits, resources, and services including available options for long term care community or facility-based service delivery.
• Provide education, resources, and assistance to help members achieve goals as outlined in their plan of care and to overcome obstacles to achieving optimal care in the least restrictive environment.
• Develop a plan of care in conjunction with members or caregivers to identify services to meet the member’s specific needs, and goals.
• Identify resources needed for a fully integrated care coordination approach including facilitating referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, and Complex Case Management.
• Collaborate with the member's health care and service delivery team including the DSHP Plus LTSS Member Advocate, ICT, and discharge planners, to coordinate the care needs and community resources for the member to maintain the member in the least restrictive safe environment possible.
• Assist members in developing, implementing, and amending a back-up plan for gaps in provider coverage.
• Ensure approved support services are being provided as outlined in the plan of care.
• Evaluate the effectiveness of the service plan and making appropriate revisions as needed in accordance with per policy & procedures and state contractual requirements.
• Assist members in overcoming obstacles to optimal care through connection with community resources, including communicating with providers and formulating an appropriate action plan.
• Document all case management services and intervention in the electronic health record.
• Adhere to all company, State and Federal requirements related to privacy practices, HIPAA, and quality performance standards.
• Perform other duties as assigned/requested.

Required Qualifications:

• Registered Nurse in the state of DE
• 5 years of Intensive Case Management and Discharge Planning experience
• Experience completing Assessments, developing Service Plans and Care Plans
• Experience collaborating with PCP’s, Occupational Therapists, Behavioral Health, and Providers
• Experience with ordering DME Equipment
• Experience educating and providing resources for the member’s Social Determinants. They must have experience with discharging members from a Facility setting.
• Working flexible hours to meet member’s needs
• Proficiency in PC-based word processing and database documentation (Word, Excel, Internet, Outlook)
• Reliable transportation daily to be able to travel within assigned territory
• Ability to meet regulatory deadlines.
• Has a dedicated homework space used only for business purposes and is able to comply with all telecommuter policies.
• Understanding of the importance of cultural competency in addressing targeted populations.
• Experience with electronic documentation system(s)
• Experience with cost neutrality and budgeting
• Must be willing to travel throughout the state (may only need to travel 2-3 times a week depending on schedule)
• Must be able to communicate clearly to members - will be tasked with conducting assessments with members over the phone
• Must be very organized

Preferred Qualifications:

• Licensed Bachelor’s Social Worker (LBSW)
• Licensed Master’s Social Worker (LMSW)
• Licensed Clinical Social Worker (LCSW)
• Experience working with HIV/AIDS population
• Experience working with behavioral health population
• Experience working with developmental disabilities population
• Medicare and Medicaid experience

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Health and Human Services

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