Job DescriptionThis position is responsible for the assessment, reassessment, care planning and coordination of care and services for Members enrolled in the case management program. Includes ongoing monitoring of an appropriate and effective person centered care plan, member education and care coordination. Regularly communicates with the member’s PCP and other providers, and integrates the member, caregiver and other provider feedback into the assessment and planning.
- Maintains a caseload of members enrolled in the case management program, including risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings.
- Serves as the primary point of contact throughout the treatment episode at the levels of care.
- Coordinates with the interdisciplinary team of providers, vendors, facilities, discharge planners, nurses, social workers, care coordinators, and member/caregivers to effectively manage care plans and transitions of care settings.
- Maintains timely, complete and accurate documentation in compliance with regulatory policies and procedures.
- Participates in complex case rounds and/or meetings and consults with Physician Adviser/Medical Director on regular basis concerning the progress of members.
- Provides consultation to PCP/Providers as indicated with consent of client. Identifies barriers to accessing services and assists members as needed.
- Participate actively in the Quality Improvement program.
- Other duties as assigned.
General Job Information
TitleCase Manager RN (MSK Pain Program)
Job FamilyClinical Services Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date4/15/2019
Date Requisition Created4/10/2019
License and Certifications - RequiredRN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt
License and Certifications - PreferredCCM - Certified Case Manager - Care Mgmt
Other Job Requirements
- RN licensure.
- Proficient computer skills, including ability to converse and type at a conversational pace.
- Solid understanding of behavioral health diagnoses.
- Strong organization, time management and verbal and written communication skills.
- Knowledge and experience in working with case management and in facilities, with local care coordinators or with special populations.
- Knowledge of DSM V or most current diagnostic edition.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
“I receive a high level of support from our Senior Management Team to execute on our vision. They are always accessible and approachable, something I’ve found to be very unique to Magellan.”