RN Case Manager - CareVio Outpatient

RN Case Manager - CareVio - Outpatient

Hybrid position 8-4:30 with 1 evening requirement

Wilmington, DE

ChristianaCare CareVio is hiring an RN Case Manager. The Case Manager is responsible for the coordination of care for a complex patient population with medical and social determinants of health needs. The Case Manager works to improve outcomes and reduce preventable readmissions. The Case Manager will coordinate the utilization of healthcare resources, including planning transitions, facilitating the achievement of quality, clinical, financial, and member satisfaction goals.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

• Perform ongoing telephonic case management activities of assessment, problem identification, planning, implementation, coordination, monitoring, and evaluation of case managed members.
• Collaborates with patients, caregivers, and members of the multi-disciplinary care team to develop a member centered plan of care to meet identified member care goals and outcomes.
• Develop, implement, evaluate, and revise case management care plans according to case management eligibility criteria, contractual guidelines and members physical and psychological needs throughout the continuum of care.
• Identifies system issues that serve as barriers to care. Participates in development and implementation of strategies to remove barriers and promote resolution through coordination of a problem-solving process.
• Promote member wellness and autonomy through advocacy, communication, education, and identification and referral to community resources or other case management programs such as disease management programs.
• Identify appropriate providers and facilities through the continuum of services and ensure that available resources are being used timely and cost-effective manner.
• Collaborate with transitional, embedded, and inpatient case managers in the discharge and transitional care process, obtaining and/or coordinating appropriate resources for members throughout the continuum of care.
• Stratifies and/or validates member level of risk during each transition process and interaction with the member.
• Collaborates with health care providers in settings not limited to the PCP office, hospital, skilled nursing facility or home care agencies to assist members in coordinating safe

• transitions and enhanced communication of the treatment plan to all members of the multidisciplinary care team
• Makes referrals to the pharmacist, social worker, or community outreach team as needed to provide holistic approach of care.
• Manages assigned case load in an efficient and effective manner utilizing time management skills to facilitate the total work process directly monitoring assigned members.
• Demonstrates knowledge of utilization management and care coordination processes and current standards of care as a foundation for transition planning, complex case management and disease management activities
• Confers with Medical Directors regarding complex cases requiring physician input regarding the treatment plan or physician to treating physician collaboration.
• Adheres to organizational and departmental policies and procedures and credentialed compliance.
• Performs assigned work safely, adhering to established departmental safety rules and practices. Reports to supervisor, in a timely manner, any unsafe activities, conditions, hazards, or safety violations that may cause injury to oneself, other employees, members and visitors.
• Performs all other related duties as assigned by Manager/Director

ChristianaCare Offers:

• Full Medical, Dental, Vision, Life Insurance, etc.
• Two retirement planning offerings, including 403(b) with company contributions.
• Generous paid time off with annual roll-over and opportunities to cash out.
• 12 week paid parental leave.
• Tuition assistance
• Incredible Work/Life benefits including annual membership to care.com, access to backup care services for dependents through View email address on apply.j-vers.com, retirement planning services, financial mentor, fitness and wellness reimbursement, and great discounts through several vendors for hotels, rental cars, theme parks, shows, sporting events, movie tickets and much more!

Education & Special Requirements:

• Registered Nurse with BSN required.
• Active DE RN Licensure or Compact Licensure, in good standing
• Ability to obtain a non-compact state RN Licensure as needed
• Active Basic Life Support (BLS) certification
• Relevant experience in Utilization Management or Case Management required.
• Case Management Certification required through the Commission for Case Management (CCM) or American Case Management Association within 18- months of eligibility.
• Advanced Certification recommended.

PHYSICAL DEMANDS:

• Ability to ambulate within an office setting (walking, stairs, etc.)
• Occasional sitting, standing, and lifting loads of 5-10 pounds.

Hourly Pay Range: $42.11 - $67.37

This pay rate/range represents ChristianaCare’s good faith and reasonable estimate of compensation at the time of posting. The actual salary within this range offered to a successful candidate will depend on individual factors including without limitation skills, relevant experience, and qualifications as they relate to specific job requirements.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.