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

Role Description

Acentra Health is looking for a Nurse Case Manager to join our growing team now!

The Nurse Case Manager 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.

Position is remote, but candidates must reside in California, preferably in Los Angeles or San Diego area.

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 other Health 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.
• This position primarily involves working at a desk and using a computer for extended periods of time.
• Other duties as assigned.

Qualifications

• Bachelor’s degree/BSN.
• Active, unrestricted RN (Registered Nurse) license in CA.
• A minimum of 3+ years of clinical experience.
• A minimum of 1+ years of case management review experience.
• Must reside in the state of CA.
• Successful communication (written/verbal), with a strong focus on customer service, including building and maintaining relationships with internal/external customers.
• Ability to work independently and as part of a team.
• Maintain a high level of confidentiality.
• Ability to maintain metrics and goals within the department.

Requirements

• Bilingual in Spanish (preferred).
• Ability to assist members and conduct outreach to members without prior engagement (preferred).
• Strong cultural competency and the ability to work effectively with diverse populations (preferred).
• Flexibility and strong organizational skills (preferred).
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making (preferred).
• Maintain professionalism, flexibility, and dependability under pressure (preferred).
• Ability to research/identify and apply appropriate standards of care (preferred).
• Interest in continuous learning and a commitment to staying informed on regulatory changes (preferred).

Benefits

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

Company Description

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities.

At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision-making, and drive better health outcomes.