Case Manager

Case Manager

Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances. At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.

Job Description

Dept: BCCC Commercial Operati

This position is fully remote; candidates will not be required to work onsite.

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.

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 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).

Education and Experience

1. Nursing Diploma or Associates degree in nursing required. 2. Bachelor's degree in nursing strongly preferred. 3. 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required. 4. 1 year of case management experience in a managed care setting strongly preferred. 5. Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.

Certificates, Licenses, Registrations

1. Current, active, and unrestricted Michigan Registered Nurse license required 2. Certification in Case Management (CCM) preferred 3. Certification in Chronic Care Professional (CCP) preferred

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 include:

• 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.

Location

Detroit, MI

Kyyba is an Equal Opportunity Employer. Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. Minorities / Females / Protected Veterans / Individuals with Disabilities are encouraged to apply. All employment is decided on the basis of qualifications, merit, and business need.

It is the policy of Kyyba to provide reasonable accommodation when requested by a qualified applicant or employee with a disability, unless such accommodation would cause an undue hardship. The policy regarding requests for reasonable accommodation applies to all aspects of employment, including the application process. If reasonable accommodation is needed, please contact Kyyba at View phone number on click.appcast.io

Rewards

Medical, dental, vision 401k Term life Voluntary life and disability insurance Optional Pre-paid legal plan Optional Identity theft plan Optional Medical and dependent FSA Work-visa sponsorship Opportunity for advancement Long-term assignment with opportunity for hire by client

Select Awards

• An INC 5000 company for 10 years
• Corp! Michigan Economic Bright Spots
• Crain's Detroit Business Top Staffing Service Companies in Detroit
• TechServe Alliance Excellence Award- IT and Engineering Staffing & Solutions
• Best of MichBusiness winner in HR Wizards & Partnerships
• Metro Detroit Elite Category: Recruitment, Selection & Orientation for 101 Best & Brightest
• 101 Best & Brightest Companies to Work for in Michigan