ACHN RN Care Manager

About the role

This position performs care management for recipients assigned by the State of Alabama Medicaid Office. The role provides care management for recipients enrolled in programs designated by State of Alabama Medicaid, ensuring sound care plans are developed and acted upon in a timely manner to improve the recipient’s overall health. This care management frequently involves face-to-face meetings with recipients to gain a full understanding of their challenges. The position primarily serves home care and community-based populations needing care management and transitional services from inpatient facilities.

Responsibilities

• Develop and implement sound care plans for Medicaid recipients to improve overall health outcomes.
• Conduct face-to-face meetings with recipients to assess challenges and needs.
• Provide care management and transitional services for home care and community-based populations.
• Document electronic case records, including writing effective care plans and SMART goals.
• Manage a heavy caseload while analyzing clinical situations and making informed decisions.
• Engage recipients in their plan of care through strong verbal and written communication.
• Collaborate with medical providers and community resource agencies.
• Travel as required for job-related duties.

Requirements

• Bachelor of Science in Nursing or Associate Degree or Diploma in Nursing.
• Active Alabama license in good standing as a Registered Nurse (RN).
• Must live and work within the region or adjoining county.
• Strong verbal and written communication skills.
• Ability to sufficiently document electronic case records, including care plans and SMART goals.
• Experience managing a heavy caseload and analyzing clinical situations.
• Demonstrated exceptional written, verbal, and interpersonal communication skills.
• Experience exercising independent judgment and decision-making.
• Experience working with medical providers and/or community resource agencies.
• Willingness to travel as required for the job.

Qualifications

For Associate Degree in Nursing (ADN) Only:

• Two (2) years of recent experience working in a clinic setting or combined hospital experience.
• Minimum of one (1) year experience in care coordination/case management working with low-income and diverse populations, including experience with Medicaid recipients receiving care coordination/case management services.

Preferred Qualifications

• Two years of complex pediatric experience.
• Experience working in a home setting as a Case Manager or Care Coordinator.
• Knowledge of Alabama Medicaid regulations and guidelines.
• Knowledge of community-based agencies and resources.
• Experience working in a behavioral health hospital or residential facility.