Case Management Nurse

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This range is provided by OpTech. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more.
Base pay range

$37.00/hr - $39.00/hr
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OpTech has a top tier health insurance client with multiple hiring needs and openings!!
Excellent opportunity for

Case Management / Case Manager RNs!!
MUST HAVE:

Active RN license, State of MI
100% remote.
Contract, to possibly Contract to Hire
Paid orientation and 8-week training!
Strongly Preferred Experience:
Pediatrics, SNF/SAR/LTAC, Hospital or other facility case management, Home health care, ER, ICU/Step-down, Utilization Management
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 Our Client’s 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.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. 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 members 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)
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER SKILLS AND ABILITIES
Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member’s outcomes
Empathetic, supportive and a good listener
Proficient in motivational interviewing skills
Demonstrated time management skills
Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member
Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.)
Must embrace teamwork but can also work independently
Excellent interpersonal and communication skills both written and verbal
Preferred Experience:
Pediatrics, SNF/SAR/LTAC, Hospital or other facility case management, Home health care, ER, ICU/Step-down, Utilization Management
EDUCATION AND EXPERIENCE
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
CERTIFICATES, LICENSES, REGISTRATIONS
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
OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws.

self identification/
OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits on the first day of employment, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, pleas e visit our website at

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Seniority level

Seniority level Mid-Senior level
Employment type

Employment type Contract
Job function

Job function Health Care Provider
Industries IT Services and IT Consulting
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