Case Manager

Urgent Requirement of Registered Nurse /Case Manager with home care & children special needs experience in Columbus Ohio

• A minimum of 1 year Home Health experience, or Case Management experience.

Home Visits: Working with children with special needs, will meet with member, and guardian. No clinical care.

• Position requires RN License, must be licensed for the state of Ohio.

• Interview: Face to Face

• Training: One-on-one training with Manager at the members’ homes

• Temps need to have flexibility with schedule as some days they will be starting as early as 5:00 am and ending as late as 7:00 pm, but only working an 8 hour shift.

• Working in Office- but need to be mobile as they will be making visits for home assessments.

• While in office: Reviewing Assessment with medical directors to determine if patients are receiving the level of in home care and if they need referrals as well.

Essential Functions:

• Provides case management services to members with chronic or complex conditions including: Proactively identifies members that may qualify for potential case management services.

• Conducts assessment of member needs by collecting in-depth information from information system, the member, family/caregiver, hospital staff, physicians and other providers.

• Identifies, assesses and manages members per established criteria.

• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.

• Performs ongoing monitoring of the plan of care to evaluate effectiveness.

• Documents care plan progress in client’s information system.

• Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. Measures the effectiveness of interventions to determine case management outcomes.

• Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for client’s members.

• Conducts face to face or home visits as required.

• Maintains department productivity and quality measures.

• Manages and completes assigned work plan objectives and projects in a timely manner.

• Demonstrates dependability and reliability.

• Maintains effective team member relations.

• Adheres to all documentation guidelines.

• Attends regular staff meetings.

• Participates in Interdisciplinary Care Team (ICT) meetings.

• Assists orientation and mentoring of new team members as appropriate.

• Maintains professional relationships with provider community and internal and external customers. Conducts self in a professional manner at all times.

• Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct. Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.

• Complies with required workplace safety standards.

Knowledge/Skills/Abilities:

• Demonstrated ability to communicate, problem solve, and work effectively with people.

• Excellent organizational skill with the ability to manage multiple priorities.

• Work independently and handle multiple projects simultaneously.

• Strong analytical skills.

• Knowledge of applicable state, and federal regulations.

• Knowledge of ICD-9, CPT coding and HCPC.

• SSI, Coordination of benefits, and Third Party Liability programs and integration.

• Familiarity with NCQA standards, state/federal regulations and measurement techniques.

• In depth knowledge of CCA and/or other Case Management tools.

• Ability to take initiative and see tasks to completion.

• Computer skills and experience with Microsoft Office Products.

• Excellent verbal and written communication skills.

• Able to maintain regular attendance based upon agreed schedule.

• Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA). Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.

• Required Education: ADN Experience in home health case management0-2 years.

All your information will be kept confidential according to EEO guidelines.