Case Manager

*Overview*: TekWissen Group is a workforce management provider throughout the USA and many other countries in the world.
Our client is a health insurance company.
It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.
*Description: * * "The Care Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs.
* They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the client online messaging platform.
* The Care Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member’s health across the care continuum.
* They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.
*ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.
Other duties may be assigned: * * Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally.
* The multidisciplinary team is inclusive of Medical and Behavioural Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors.
* Use the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the members’ health across the care continuum.
* Assess the member's health, psychosocial needs, cultural preferences, and support systems.
* Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes.
* Arrange resources necessary to meet identified needs (e.
g.
, community resources, mental health services, substance abuse services, financial support services and disease-specific services).
* Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.
* Advocate for members and promote self-advocacy.
* Deliver education to include health literacy, self-management skills, medication plans, and nutrition.
* Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary.
* Accurately document interactions that support management of the member.
* Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.
* Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.
* Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.
* Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals.
* Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).
*EDUCATION AND EXPERIENCE * * Nursing Diploma or Associates degree in nursing required.
* Bachelor’s degree in nursing strongly preferred.
* 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
* 1 year of case management experience in a managed care setting strongly preferred.
* Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.
*CERTIFICATES, LICENSES, REGISTRATIONS * * Current, active, and unrestricted client Michigan Registered Nurse license required * Certification in Case Management (CCM) required or to be obtained within 18 months of hire *Certification in Chronic Care Professional (CCP) preferred QUALIFICATIONS * * To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
* The requirements listed below are representative of the knowledge, skill, and/or ability required.
* Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
*OTHER SKILLS AND ABILITIES * * Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member’s outcomes.
* Empathetic, supportive and a good listener.
* Proficient in motivational interviewing skills.
* Demonstrated time management skills.
* Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member.
* Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.
).
* Must embrace teamwork but can also work independently.
* Excellent interpersonal and communication skills both written and verbal.
" *TekWissen® Group is an equal opportunity employer supporting workforce diversity.
* Job Types: Full-time, Contract Pay: $30.
00 - $35.
00 per hour Application Question(s): * Do you have Michigan Registered Nurse License? * How many years of experience in Case Manager? * How many years of experience in Clinical Nursing? * How many years of experience in Acute / Post-Acute Care? Ability to Relocate: * Detroit, MI 48226: Relocate before starting work (Required) Work Location: In person