RN Case Manager - Michigan RN License

ICONMA, LLC.; Detroit (MI); Remote; USD 70,000 - 100,000; Full time

Benefits offered by this job

Health benefits

Referral program

Job summary

ICONMA, LLC. is seeking a remote RN Case Manager to support a Michigan health plan. You will coordinate a multidisciplinary team, assess needs, and develop individualized care plans for members across the care continuum.

The role requires an active Michigan RN license, 3 years of clinical nursing, and CCM certification within 18 months; BSN is preferred and experience with telephonic/digital care is valued.

Qualifications

• Nursing Diploma or ADN required; BSN strongly preferred.
• 3 years of clinical nursing experience in acute/post-acute and community care.
• 1 year of case management experience in managed care preferred.
• Active Michigan RN license required; CCM certification within 18 months.
• Proficient in telephonic and digital care coordination.

Responsibilities

• Coordinate multidisciplinary team to deliver holistic care management.
• Act as single point of contact for members, caregivers, and providers.
• Develop, implement, monitor, and evaluate care plans.
• Engage members to address barriers and promote health outcomes.
• Arrange resources and advocate for self-management education.
• Document all interactions to support continuity of care.

Skills

Interpersonal skills

Communication skills

Digital communication

Education

Nursing diploma or ADN

BSN preferred

Tools

Excel

OneNote

Outlook

Teams

Word

Job description

Our client, a Health Insurance company, is looking for a RN Case Manager to work remotely in Michigan.

Responsibilities:

• The Case Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs.
• They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the Client online messaging platform.
• The Case Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member’s health across the care continuum.
• They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.
• Other duties may be assigned:
• Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally.
• The multidisciplinary team is inclusive of Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors.
• Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members’ health across the care continuum.
• Assess the member's health, psychosocial needs, cultural preferences, and support systems.
• Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes.
• Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services).
• Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
• Advocate for members and promote self-advocacy.
• Deliver education to include health literacy, self-management skills, medication plans, and nutrition.
• Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary.
• Accurately document interactions that support management of the member.
• Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
• Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.
• Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
• Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals.
• Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).

Requirements:

• Nursing Diploma or Associates degree in nursing required; Bachelor’s degree in nursing strongly preferred.
• 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
• 1 year of case management experience in a managed care setting strongly preferred.
• Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.
• Current, active, and unrestricted Michigan Registered Nurse license required
• Certification in Case Management (CCM) required or to be obtained within 18 months of hire
• Certification in Chronic Care Professional (CCP) preferred
• Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.).
• Excellent interpersonal and communication skills both written and verbal.

Why Should You Apply?

• Health Benefits
• Referral Program