Case Manager

Integrated Resources Inc.; Columbus (OH); On-site; USD 60,000 - 90,000; Full time

Job summary

A leading company in strategic workforce solutions is urgently seeking a Registered Nurse/Case Manager with home care and children special needs experience in Columbus, Ohio. The position involves case management services, home visits, and coordination of care for clients. Candidates should have a minimum of 1 year of relevant experience and hold a valid RN license for Ohio. This role is essential for enhancing the integration of services for clients with complex health needs.

Qualifications

• RN License required in Ohio.
• Experience in home health or case management is needed (minimum 1 year).
• Knowledge of ICD-9, CPT coding, and HIPAA compliance.

Responsibilities

• Provide case management services for members with chronic or complex conditions.
• Conduct assessments and develop case management plans.
• Document care plan progress and evaluate outcomes.

Skills

Communication

Problem Solving

Organizational Skills

Analytical Skills

Interpersonal Skills

Education

ADN in Nursing

Tools

Microsoft Office

Job description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

Job Description

Urgent Requirement of Registered Nurse /Case Manager with home care & children special needs experience in Columbus Ohio

Qualifications

• A minimum of 1 year Home Health experience, or Case Management experience.

Home Visits: Working with children with special needs, will meet with member, and guardian. No clinical care.

• Position requires RN License, must be licensed for the state of Ohio.

• Training: One-on-one training with Manager at the members’ homes

• Temps need to have flexibility with schedule as some days they will be starting as early as 5:00 am and ending as late as 7:00 pm, but only working an 8 hour shift.

• Working in Office- but need to be mobile as they will be making visits for home assessments.

• While in office: Reviewing Assessment with medical directors to determine if patients are receiving the level of in home care and if they need referrals as well.

Essential Functions :

• Provides case management services to members with chronic or complex conditions including: Proactively identifies members that may qualify for potential case management services.

• Conducts assessment of member needs by collecting in-depth information from information system, the member, family/caregiver, hospital staff, physicians and other providers.

• Identifies, assesses and manages members per established criteria.

• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.

• Performs ongoing monitoring of the plan of care to evaluate effectiveness.

• Documents care plan progress in client’s information system.

• Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. Measures the effectiveness of interventions to determine case management outcomes.

• Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for client’s members.

• Conducts face to face or home visits as required.

• Maintains department productivity and quality measures.

• Manages and completes assigned work plan objectives and projects in a timely manner.

• Demonstrates dependability and reliability.

• Maintains effective team member relations.

• Adheres to all documentation guidelines.

• Attends regular staff meetings.

• Participates in Interdisciplinary Care Team (ICT) meetings.

• Assists orientation and mentoring of new team members as appropriate.

• Maintains professional relationships with provider community and internal and external customers. Conducts self in a professional manner at all times.

• Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct. Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.

• Complies with required workplace safety standards.

Knowledge/Skills/Abilities:

• Demonstrated ability to communicate, problem solve, and work effectively with people.

• Excellent organizational skill with the ability to manage multiple priorities.

• Work independently and handle multiple projects simultaneously.

• Strong analytical skills.

• Knowledge of applicable state, and federal regulations.

• Knowledge of ICD-9, CPT coding and HCPC.

• SSI, Coordination of benefits, and Third Party Liability programs and integration.

• Familiarity with NCQA standards, state/federal regulations and measurement techniques.

• In depth knowledge of CCA and/or other Case Management tools.

• Ability to take initiative and see tasks to completion.

• Computer skills and experience with Microsoft Office Products.

• Excellent verbal and written communication skills.

• Able to maintain regular attendance based upon agreed schedule.

• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.

• Required Education: ADN Experience in home health case management0-2 years.

Additional Information

All your information will be kept confidential according to EEO guidelines.