As an RN Case Manager, you will engage with members either face-to-face in community settings or via phone to conduct thorough assessments and collaboratively develop care plans. Using motivational interviewing, active listening, and problem-solving skills, you will empower members to achieve their healthcare goals. Your role will involve identifying urgent situations, educating on health and wellness, and connecting members with community resources. Excellent documentation and technical skills are crucial for navigating various computer applications.
Primary Responsibilities
Engage with members in community or telephonic settings.
Conduct comprehensive bio-psychosocial, functional, and behavioral health assessments.
Utilize motivational interviewing and active listening during assessments.
Collaborate with members to develop personalized care plans.
Identify and escalate urgent member situations as needed.
Assist members in setting and achieving healthcare goals.
Educate members on health and wellness strategies for self-management.
Connect members with appropriate community resources.
Present complex cases to interdisciplinary care teams for review and guidance.
Use computer applications (e.g., Excel, Word, Outlook) for documentation and communication.
Document assessments, interactions, referrals, and follow-up plans accurately.
Stay updated on computer system changes and apply knowledge effectively.
Meet performance goals within a virtual environment.
Required Qualifications
Reside in the Philadelphia, PA region.
Bachelor's degree or Associate degree with RN license.
Unrestricted Registered Nurse license in PA.
4+ years of experience in Case Management or Care Coordination.
Experience with populations having complex medical or behavioral health needs.
Proficiency in Microsoft products (Excel, Outlook); ability to learn clinical applications.
Dedicated home workspace with secure high-speed internet (cable/DSL).
Valid driver's license, auto insurance, and ability to travel for occasional field visits.
Strong commitment to assisting members with complex needs.
Preferred Qualifications
Background in Managed Care.
Certified Case Manager (CCM) certification.
Bilingual proficiency a plus.
Experience in utilization review, concurrent review, and/or risk management.
Employment Type: Full-Time
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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