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Clinical - Care Manager (RN) - J01007

Mindlance

Remote-OH, OH(remote)

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JOB DETAILS
SKILLS
Case Management, Centers for Medicare and Medicaid Services (CMS), Certified Case Manager (CCM), Change Management, Child and Youth Services, Communication Skills, Computer Skills, Computer Testing, Disease, Diversity, Establish Priorities, Health Plan, Healthcare, Healthcare Providers, Home Care, Identify Issues, Laptop PC, Leadership, Maintain Compliance, Member Orientation, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft PowerPoint, Microsoft Product Family, Microsoft Word, Needs Assessment, Nursing, Nursing Credentials, Pediatrics, Performance Metrics, Registered Nurse (RN), Testing, Third-Party Payer, Time Management, Willing to Travel
LOCATION
Remote-OH, OH(remote)
POSTED
1 day ago
Job Profile Summary:

Position Purpose:
Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families.

Education/Experience:
Requires a Degree from an Accredited School of Nursing or a Bachelor's degree in Nursing and 2 4 years of related experience.

License/Certification:
RN - Registered Nurse - State Licensure and/or Compact State Licensure required

For YouthCare Illinois plan only: Bachelor s Degree and IL RN licensure required. Must reside in IL

For Sunshine Health (FL) Only: Employees supporting Florida's Children s Medical Services (CMS) must have a minimum of two years of pediatric experience. May require up to 80% local travel required

Responsibilities:
Evaluates the needs of the member, barriers to accessing the appropriate care, social determinants of health needs, focusing on what the member identifies as priority and recommends and/or facilitates the plan for the best outcome

Develops ongoing care plans / service plans and collaborates with providers to identify providers, specialists, and/or community resources to address member's unmet needs

Identifies problems/barriers to care and provide appropriate care management interventions

Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services

Provides ongoing follow up and monitoring of member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / unmet needs

Provides resource support to members and care managers for local resources for various services (e.g., employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans, as appropriate

Facilitate care management and collaborate with appropriate providers or specialists to ensure member has timely access to needed care or services

May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources

Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators

Provides and/or facilitates education to members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits

Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner

Other duties or responsibilities as assigned by people leader to meet business needs
Performs other duties as assigned.

Complies with all policies and standards.

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Story Behind the Need
  • What is the purpose of this team?
  • Describe the surrounding team (team culture, work environment, etc.) & key projects.
  • Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?
Develops, assesses, and facilitates complex care management activities for primarily physical needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families

Everyone works together to ensure our members get the care and services they need to remain as independent as possible

N/A
Typical Day in the Role
  • Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
  • What are performance expectations/metrics?
  • What makes this role unique?
 Log on laptop by 8am, review emails, tasks, and voicemails and respond to any urgent needs. Review calendar for possible meetings and/or scheduled visits. Staff typically arrange their days with the expectation of 5-7 visits required weekly. Documentation must be completed within 24 hours.

Performance expectations: 5-7 in home visits weekly, ensuring documentation is completed within 24 hours. Must meet required turn-round times for processes, and completing required trainings timely.

Working with amazing coworkers and leadership, while also caring for those individuals in need. Staff at Buckeye have worked here for years, there isn t a high turnover rate.

Looking for an experienced RN with 2-4 years of experience in case management or home health experience
Candidate Requirements
Education/Certification Degree from an Accredited School of Nursing and 2 4 years of related experience Preferred: 2-4 years of related experience in case management or home health experience
Licensure Required: Ohio RN Licensure Preferred: Ohio RN Licensure
Years of experience required: 2-4 years of experience nursing, case management, home health, reliable vehicle for weekly travel

Disqualifiers: Inability to work independently, manage change well, inability to utilize technology and Microsoft Office

Additional qualities to look for: Someone who works well independently, personable, strong communication skills. Someone who can think critically, be flexible, open to change, and can also work well on a team.

During 5 week training they will not be able to miss any days of training. They must be able to attend ALL training classes and modules.
  • Top 3 must-have hard skills stack-ranked by importance
 1 Computer Literate IS A MUST (knowledge of Microsoft) Excel, Word, Team, Outlook, One note, One Drive, Powerpoint, Explorer, Chrome
2 Critical Thinker
3 Works well independently, troubleshooting
Candidate Review & Selection
  • Shortlisting process
  • Candidate review & selection
  • Interview information
  • Onboard process and expectations
 Projected Manager Candidate Review Date: 24-48 hours of qual

Type of Interviews:
 Teams CAMERA ON
Required Testing or Assessment (by Vendor): Agencies must perform computer literacy test - Excel, Word, Team, Outlook, One note, One Drive, Powerpoint, Explorer, Chrome
Next Steps
  • Do you have any upcoming PTO?
 No
  • Colleagues to cc/delegate
 N/A

About the Company

M

Mindlance