RN Case Manager

Location: Scottsdale, AZ
Date Posted: 03-11-2019
Case Management RN – Managed Care
Scottsdale, AZ (Phoenix East Valley)
Case Manager Job Summary:
  • The RN Case Manager will be responsible for the development of patient focused care delivery plans, along with coordinating, monitoring and evaluating the execution of the plans. 
  • The Case Manager will facilitate cost effective and quality patient care.
  • The Case Manager will act as a patient advocate and navigator by facilitating continuity of patient care and care transitions with external healthcare organizations and facilities. 
  • The Case Manager will also promote clear communication among the care team and treating clinicians by ensuring awareness regarding patient care plans.
  • The Case Manager will monitor the delivery of care by documenting care, identifying progress toward desired care outcomes and intervening to overcome deviations from the plan. 
  • They will assist staff in maintaining balance between the needs of the patient, physician(s) and contracted health plan.
  • The position will assist with data collection, health outcomes reporting and clinical audits.
  • The coordinator is also responsible for monitoring utilization and, if necessary, discuss utilization of services with provider and recommending alternative options when appropriate.
  •  Develops and executes interdisciplinary care delivery plans by facilitating continuity of care and managing care transitions with external entities/physicians.
  • Communicates care plans to care team members, facilitates scheduling procedures and/or appointments and implements organizational standards of care.
  • Monitors delivery of patient care by documenting care, verifying findings and reports, identifying progress or deviation from the plan, intervening to overcome deviation in the plan, and communicating regular updates to the appropriate caregivers.
  • Assists with data collection and evaluates outcomes of care and intervention effectiveness. 
  • Works with care delivery team to recommend changes to improve the quality of care while being cost effective.  
Case Manager Background: 
  • Valid, unrestricted state Registered Nurses (R.N.) license.
  • Prefer candidates that have a Bachelors of Science in Nursing or Social Work.
  • Roughly 3-5 years of hospital, acute care clinical nursing experience.
  • Around 2-3 years’ experience in a Managed Care Organization (Health Plan/HMO/MSO/TPA/IPA/etc).
  • At least 1-2 years’ experience with medical or behavioral case management or care coordination; inpatient settings preferred.
  • Experience working with Federal and State assistance programs (Medicare/Medicaid/etc).
  • Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts.
  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
410.983.9864 (CALL – TEXT – FAX)
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