RN Case Manager - Medicare Advantage Care Coordinator

American Health Partners; Fort Wayne (IN); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Annual performance wage increases

401k retirement plan with a company ma

Medical, dental and vision insurance

$50,000 basic life insurance – paid by

Paid time off

UKG Wallet – access your pay faster!

Holiday pay

Telehealth through 98point6 – free to

Continuing Education opportunities

Career Advancement Opportunities

Job summary

American Health Partners in Fort Wayne, IN seeks an experienced RN Case Manager to oversee care coordination for Medicare Advantage members. You will visit patients, coordinate with physicians, and develop and evaluate care plans with the health care team.

The role requires RN licensure with 2+ years in clinical nursing and managed care; CCM preferred. We offer competitive benefits and opportunities for advancement.

Qualifications

• Minimum of 2 years of clinical nursing or rehabilitation for the geriatric population.
• 2-years managed care experience required.
• 3-5 years’ experience doing case management in a managed care environment preferred.
• Current RN license in assigned state.
• CCM license preferred.
• CPR for Healthcare Professionals certification.
• Current valid driver’s license and motor vehicle insurance.

Responsibilities

• Complete Health Risk Assessments for members as assigned.
• Initiate, update and/or revise care plans as needed.
• Maintain a caseload of patient as assigned.
• Collaborates with interdisciplinary health team to plan and reevaluate care.
• Provide patient/family education based on identified learning needs.
• Educate Home/Facility staff as needed.
• Coordinate outpatient discharge planning based on patient needs.
• Participate in Managed Care audits and generate reports via MS Office.
• Engage in improvement projects, data collection and audit findings.
• Participate in patient care conferences and staff development.
• Apply medical management criteria correctly.
• Research clinical questions from employers, members and payers.
• Educate members on health access options.
• Respond to day-to-day problems in care coordination.
• Other duties as assigned.

Skills

Nursing experience

Case management

Communication skills

Education

RN license

Bachelor's degree preferred

Job description

American Health Partners in Fort Wayne, IN seeks an experienced RN Case Manager to oversee care coordination for Medicare Advantage members. You will visit patients, coordinate with physicians, and develop and evaluate care plans with the health care team.

The role requires RN licensure with 2+ years in clinical nursing and managed care; CCM preferred. We offer competitive benefits and opportunities for advancement.