[Hiring] Case Manager - RN @Acentra Health, LLC

Role Description

Acentra seeks a Part-Time Case Manager - RN, Mid to join our growing team.

The Case Manager, RN, will evaluate beneficiaries' needs, develop individualized care plans, and coordinate healthcare team members to ensure optimal client outcomes while adhering to payer requirements. They also facilitate integrated case and disease management activities based on CMSA principles, aiming to stabilize beneficiaries' health and avoid long-term care placement.

Job Responsibilities:

• Assess, plan, implement, monitor, and evaluate options and services to affect an appropriate, individualized plan with the beneficiary across the continuum of care.
• Utilize clinical knowledge and competence, communication skills, problem-solving, and conflict resolution to ensure optimal beneficiary outcomes with consideration to client requirements effectively.
• Develop beneficiary-centered care plans.
• Demonstrate shared accountability between beneficiaries, caregivers, and providers.
• Work collaboratively with the beneficiary, provider, and Health Plan Care team members to coordinate care.
• Address identified gaps in care or compliance.
• Maintain strict standards for client confidentiality and client-related information.
• Comply with all organizational, state, and federal regulations and policies on confidentiality.
• Manage caseload to ensure all required documentation and entry of assessment results into the web-based database are completed accurately and timely, following regulatory requirements and company policies and procedures.
• Maintain open communication with all appropriate parties.
• Pursue ongoing education, certification, and self-development to remain current with case management standards.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Qualifications

Required Qualifications:

• Current, unrestricted Registered Nurse (RN) license in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline.
• 3 - 5 years RN clinical experience required.

Preferred Qualifications:

• BSN and CCM preferred.
• Proficiency in using Microsoft Word, Excel, and other applications in the Microsoft Office suite.
• Excellent written and verbal communication skills.
• Ability to work effectively in a team environment.
• Maintain a high level of confidentiality.
• Good problem-solving skills.
• Ability to maintain metrics and goals within the department.
• Work telephonically, and with computer systems.
• Assist members and conduct outreach to members without prior engagement.
• Flexibility and strong organizational skills.
• Strong understanding of cultural competency when working with the population.
• Experience with Medicaid, Medicare or Commercial health plans.
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making.
• Demonstrated initiative and judgment in the performance of job responsibilities.
• Maintain professionalism, flexibility, and dependability under pressure.
• Strong communication (written/verbal), interpersonal, organizational, time management and communication skills with a strong focus on customer service, including building and maintaining relationships with internal/external customers and facilitating meetings.
• Ability to work independently and as part of a team.
• Ability to research/identify and apply appropriate standards of care.
• Interest in continuous learning and a commitment to staying informed on regulatory changes.

Benefits

• Comprehensive health plans.
• Paid time off.
• Retirement savings.
• Corporate wellness.
• Educational assistance.
• Corporate discounts.
• And more.