Case Manager RN

Acentra; Northern (KY); Hybrid; USD 67,000 - 93,000; Full time

Job summary

Acentra Health seeks a Case Manager RN to join our growing team, overseeing care coordination for beneficiaries and ensuring quality outcomes across social, medical, and behavioral services. The role requires current RN licensure, at least 2 years of clinical experience, and 1+ year in case management or home care.

The position emphasizes collaboration with multidisciplinary teams, adherence to HIPAA and regulatory standards, and ongoing professional development within a supportive health

Qualifications

• Current, active and unrestricted Oregon Registered Nursing license
• Associate's degree in nursing or bachelor's degree from an accredited college or university
• 2+ years clinical experience
• 1+ years case management or home care experience

Responsibilities

• Provide care coordination/care management for beneficiaries, ensuring a high level of clinical knowledge and performance by the clinical team
• Foster a caring philosophy in leadership and all aspects of the care management process
• Manage the care of beneficiaries through the healthcare system based on their individual needs for social, physical, vision, dental, behavioral, pharmacy, and preventative health services
• Use independent judgment and discretion to address and proactively resolve barriers impeding diagnostic, social or treatment progress
• Interact and collaborate with a multidisciplinary care team, including physicians, nurses, case managers, OHA staff, and social workers/educators to ensure as well as participate in IDT meetings beneficiary needs and preferences for health services/information are shared
• Educate beneficiaries about community resources/options and advocate on behalf of the beneficiary
• Complete health and social assessments for the purposes of care planning using motivational interviewing, trauma informed care and equity principles for all engagements
• Establish a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality outcomes
• Maintain operational requirements for caseload management, securing PHI, working from a plan of care, documentation standards, and other program standards
• Maintain strict standards for client confidentiality and client-related information
• Comply with all organizational, state, and federal regulations and policies on confidentiality
• Prepare documentation, status updates, event notifications, and other documentation regarding beneficiaries in accordance with regulatory requirements and company policies and procedures
• Monitor case load to ensure all required documentation, plan of care, and entry of assessment results into a web-based database are completed accurately and promptly
• Pursue ongoing education, certification, and self-development to remain current with case management standards
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
• Other duties as assigned

Skills

CCM certification

Multi-tasking

Attention to detail

Decision-making

Communication skills

Education

Associate's degree in nursing

Bachelor's degree in nursing

Job description

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary and Responsibilities

Acentra seeks a Case Manager RN to join our growing team.

Job Summary:

The Case Manager RN will contribute to enhancing the company’s success through personalized care planning, ensuring optimal outcomes and compliance with payer standards.

Their collaboration with healthcare team members strengthens the overall effectiveness of care delivery, while their expertise in coordinating diverse beneficiary needs reflects the company’s commitment to overall well-being.

Key Responsibilities

• Provide care coordination/care management for beneficiaries, ensuring a high level of clinical knowledge and performance by the clinical team
• Foster a caring philosophy in leadership and all aspects of the care management process
• Manage the care of beneficiaries through the healthcare system based on their individual needs for social, physical, vision, dental, behavioral, pharmacy, and preventative health services
• Use independent judgment and discretion to address and proactively resolve barriers impeding diagnostic, social or treatment progress
• Interact and collaborate with a multidisciplinary care team, including physicians, nurses, case managers, OHA staff, and social workers/educators to ensure as well as participate in IDT meetings beneficiary needs and preferences for health services/information are shared
• Educate beneficiaries about community resources/options and advocate on behalf of the beneficiary
• Complete health and social assessments for the purposes of care planning using motivational interviewing, trauma informed care and equity principles for all engagements
• Establish a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality outcomes
• Maintain operational requirements for caseload management, securing PHI, working from a plan of care, documentation standards, and other program standards
• Maintain strict standards for client confidentiality and client-related information
• Comply with all organizational, state, and federal regulations and policies on confidentiality
• Prepare documentation, status updates, event notifications, and other documentation regarding beneficiaries in accordance with regulatory requirements and company policies and procedures
• Monitor case load to ensure all required documentation, plan of care, and entry of assessment results into a web-based database are completed accurately and promptly
• Pursue ongoing education, certification, and self-development to remain current with case management standards
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
• Other duties as assigned

Qualifications

Required Qualifications/Experience

• Current, active and unrestricted Oregon Registered Nursing license
• Associate's degree in nursing or bachelor's degree from an accredited college or university
• 2+ years clinical experience
• 1+ years case management or home care experience

Preferred Qualifications/Experience

• Certified Case Manager (CCM)
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines
• Superior attention to detail
• Demonstrated ability in decision-making
• Demonstrated initiative and judgment in performance of job responsibilities
• Maintain professionalism, flexibility and dependability under pressure
• Strong communication (written/verbal), interpersonal, organizational, time management and communication skills
• Exceptional customer service skills
• Ability to foster relationships with internal/external customers and facilitating meetings
• Ability to work independently and as part of a team
• Ability to research/identify and apply appropriate standards of care
• Interest in continuous learning and a commitment to staying informed on regulatory changes

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

Compensation

The pay for this position is listed below.

Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

Pay Range

USD $67,300.00 - USD $93,050.00 /Yr.

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.