12 days old

Registered Nurse RN Outpatient Case Manager Healthcare WellMed Indianapolis IN

Indianapolis, IN 46204
  • Job Code
    879762
  • Jobs Rated
    118th

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm) 


The primary responsibility of the Case Manager is to identify, screen, track, monitor and coordinate the care of members with multiple co-morbidities and/or psychosocial needs and develop a case management care plan. They will interact and collaborate with interdisciplinary care team (IDT), which includes physicians, inpatient case managers, care team associates, pharmacists, social workers, educators, health care coordinators/managers. The Case Manager also acts as an advocate for members and their families linking them to other IDT members to help them gain knowledge of their disease process(s)and to identify community resources for maximum level of independence. The Case Manager will participate in IDT conferences to review care plan and member progress on identified goals and interventions. The Case Manager may perform telephonic and/or face-to-face assessments.


Primary Responsibilities: 
  • Independently conducts initial assessments within designated timeframes for members identified as having complex case management needs (assessment areas include clinical, behavioral, social, environment and financial).
  • Collaborates effectively with IDT to establish an individualized care plan for members with interventions to assist the member in meeting short- and long-term goals . 
  • Engage patient, family, and caregivers to assure that a well-coordinated care plan is established.
  • Identifies member needs, develop care plan and prioritize goals; using evidence-based practice the Case Manager will develop interventions while considering member barriers independently.
  • Make outbound calls to assess member health status, identify gaps or barriers in care plan.
  • Provide member education to assist with self-management goals.
  • Make referrals to outside sources.
  • Educate members on disease process or acute condition and provide indicated contingency plan
  • Coordinates visits with PCP and specialists as needed on a limited basis, performs visual assessment for skin checks on exposed skin, and conducts home safety evaluation.
  • Independently confers with Market MD Medical Directors and/or PCPs on a regular basis regarding Complex Care/High Risk Population members and participates in department huddles. 
  • Enters timely and accurate data into designated care management applications and maintains audit scores of 90% or better on a monthly basis.
  • Adheres to organizational and departmental policies and procedures.
    • Takes on-call assignment as directed.
  • The Case Manager will also maintain current licensure to work in state of employment. Decision making is based on regulatory requirements, policies and procedures, and current clinical guidelines
    • Maintains current knowledge of health plan benefits and provider network including inclusions and exclusions in contract terms.
  • Monitors for quality concerns regarding member care and reports as per policy and procedure.  Performs all other related duties as assigned.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
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    Jobs Rated Reports for Registered Nurse

    Posted: 2020-09-11 Expires: 2020-10-11

    UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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    Registered Nurse RN Outpatient Case Manager Healthcare WellMed Indianapolis IN

    UnitedHealth Group
    Indianapolis, IN 46204

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    Registered Nurse
    118th2018 - Registered Nurse
    Overall Rating: 118/220
    Median Salary: $70,000

    Work Environment
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    166/220
    Stress
    High
    173/220
    Growth
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    53/220
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