Case Manager RN

About the role

Acentra Health seeks a Case Manager RN to join our dynamic team. This role contributes to enhancing the company’s success through personalized care planning, ensuring optimal outcomes and compliance with payer standards.

Responsibilities

• Provide care coordination/care management for beneficiaries, ensuring a high level of clinical knowledge and performance by the clinical team
• Foster a caring philosophy in leadership and all aspects of the care management process
• Manage the care of beneficiaries through the healthcare system based on their individual needs for social, physical, vision, dental, behavioral, pharmacy, and preventative health services
• Use independent judgment and discretion to address and proactively resolve barriers impeding diagnostic, social or treatment progress
• Interact and collaborate with a multidisciplinary care team, including physicians, nurses, case managers, OHA staff, and social workers/educators to ensure beneficiary needs and preferences for health services/information are shared
• Educate beneficiaries about community resources/options and advocate on behalf of the beneficiary
• Establish a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality outcomes
• Maintain operational requirements for caseload management, securing PHI, working from a plan of care, documentation standards, and other program standards
• Maintain strict standards for client confidentiality and client-related information
• Comply with all organizational, state, and federal regulations and policies on confidentiality
• Prepare documentation, status updates, event notifications, and other documentation regarding beneficiaries in accordance with regulatory requirements and company policies and procedures
• Monitor case load to ensure all required documentation, plan of care, and entry of assessment results into a web-based database are completed accurately and promptly
• 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
• Perform other duties as assigned

Qualifications

• Current, active and unrestricted Oregon Registered Nursing license
• Associate's degree in nursing or bachelor's degree from an accredited college or university
• 2+ years clinical experience
• 1+ years case management or home care experience

Preferred Qualifications

• Certified Case Manager (CCM)
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines
• Superior attention to detail
• Demonstrated ability in decision-making
• Demonstrated initiative and judgment in performance of job responsibilities
• Maintain professionalism, flexibility and dependability under pressure
• Strong communication (written/verbal), interpersonal, organizational, time management and communication skills
• Exceptional customer service skills
• Ability to foster 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