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- Chicago, IL
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Registered Nurse (Case Manager)
Medix • Chicago, IL
Posted 5 days ago
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The RN Case Manager will manage and track all members in the nursing homes who require a comprehensive approach to immediate and ongoing care of their complicated and/or catastrophic illnesses with duties such as care plans, progress notes, assessments, correspondence, referrals, authorizations and more:
- Visit members in the SNF to complete an assessment, develop a care/service plan that meets member needs and provide periodic follow up.
- Verifying eligibility for LTC services
- Documenting findings in the Care Management System
- Meets or exceeds timelines associated with case activities.
- Provides succinct presentation of member at ICT and solidifies plan of care with ICT.
- Completes a member assessment according to policy and procedure.
- Develops and implements a member centered care plan that recognizes the patient's risk level, priorities, member preferences and medical needs based upon screening and assessment results.
- Creates a service plan that reflects the needs identified during DON screening and is consistent with DOA policy.
- Communicates effectively with Medical Home team members and care providers to support coordinated, integrated care.
- Schedule visits with member upon member request, a change in condition, new information
- Provides information to support all service authorizations; including entering service plans in HFS systems.
- refers patients to community based resources in order to maintain levels of wellness in the members community environment
- Files and makes necessary follow-up on mandated reporting(prevention and notification of Abuse, Neglect, and Exploitation)
- Registered Nurse in the state of IL
- MCO or ACO background
- Case Management experience
- Superior critical thinking & problem solving skills
- Comfortable with being field base