Nurse Case Manager (RN)

GENERAL DESCRIPTION The Nurse Case Manager is responsible for leading and managing the care teams within their assigned region. The position focuses on staff productivity, ensuring the provision of quality care services and the reduction of unnecessary healthcare costs. The Nurse Case Manager supports a culture of compliance with all applicable federal and state regulations and works closely and collaboratively with members of the care group and regional leadership. AREAS OF RESPONSIBILITY Lead and manage a care team consisting of healthcare professionals, including nurses, social workers, therapists, and health coaches. Actively engage with patients to help them understand the company care model, their diseases, and disease‑management strategies. Monitor and enhance the productivity of the care team to ensure that all necessary assessments and patient visits are conducted efficiently. Collaborate with the team to optimize primary‑care billing, aiming for it to constitute 15% of the total allotment for the group of patients, thereby contributing to a reduction in unnecessary medical spending. Collaborate for conflict, complaint management, and resolution of any concerns (service recovery). Review programs with leadership to ensure the right care at the right time is delivered to patients, families, facilities, and other healthcare partners. Schedule and oversee the scheduling process completed by case managers, ensuring providers and other disciplines have a well‑structured and effective schedule. Promote effective two‑way communication between employees, administration and team members within the region. Provide training and guidance to staff, ensuring they understand their job responsibilities, goals, protocols, customer‑service standards, and proper use of company software systems. Participate in interviews and hire staff when necessary. Perform general administrative tasks and support other staff as needed. Use technology platforms to enhance patient care and staff productivity. Participate in coaching calls. Perform other duties as requested or required at the sole discretion of the company. Reasonable accommodations may be made under applicable law to enable individuals with disabilities to perform the essential functions. MISSION EXPECTATIONS Take responsibility for own work in completing tasks and assist others to achieve success in their daily work. Communicate, endorse, and demonstrate the company mission, vision, and values. Be punctual and maintain regular attendance. Adhere to standards of behavior, dress code, name tag, approved uniform, personnel policies, and company regulations. Attend in‑services and meetings on a regular basis. Promote a culture of outstanding customer service and strive to enhance patient experience at all times. Be available during normal work hours (additional hours may be required as needed). Deal tactfully with patients, employees, management, visitors, government agencies, and the general public, maintaining an open‑door policy for all employees. Make independent decisions when circumstances warrant. #J-18808-Ljbffr