RN Case Manager

Health Partners is hiring an RN Case Manager. This position exists to provide support to patients, their families, and physicians in addressing medical and social concerns; educate and empower patients and families to make informed personal health care decisions; and facilitate communication between patient, physician, health plan and community.

• Member Focus

  • Ensures all activities are member-focused and individualized, resulting in personalized attention to each patient’s unique needs.

  • Identifies interventions and resources to assist member reaching personal health related goals.

  • Identifies patterns and episodes of care that are predictive of future needs and services.

• Integration

  • Integrates clinical and psychosocial information for case identification and individual patient assessment to develop action-oriented and time-specific planning and implementation of appropriate interventions.

  • Facilitates integration of patient care by encouragement of effective communications between patients, families, providers, health plan and care system programs, and community-based services.

  • Adheres to department policy and procedure in daily activities.

  • Coordinates service coverage with appropriate funding sources when indicated.

  • Works with Supervisor, Case Management, Government Programs department and Member Services department to ensure compliance with Medicare requirements and regulations.

• Communication

  • Effectively communicates with patients and their families to provide them with a better understanding of their health, health care benefits, and health care system.

  • Effectively and routinely communicates with patients, families, physicians and health care team members to facilitate successful collaboration resulting in high levels of member/patient/family/provider satisfaction.

  • Provides educational information and materials to members to support preference sensitive decisions.

  • Provides regular reporting of member outcomes to Case Management leadership according to defined process.

  • Identifies and promptly reports potentially adverse situations to leadership as outlined in department policy and procedure.

  • Identifies and promptly reports high cost cases for reinsurance.

  • Maintains current and accurate documentation and case management files in accordance with Case Management policy and procedure.

  • Maintains confidentiality of information in accordance with department and corporate policies.

• Relationships and Team Building

  • Establishes and maintains good working relationships within the Case Management department, with other Health Partners departments, and with other health team participants.

  • Supports other team members in achieving patient centered goals.

  • Assists supervisor in maintaining a cohesive Case Management team by contributing to a collaborative, respectful, and diverse environment.

  • Participates in and contributes to appropriate departmental and/or organizational meetings.

• Technology

  • Maintains knowledge of and effectively uses automated applications and systems.

  • Identifies deficits in technological literacy and seeks appropriate training under guidance of supervisor.

  • Maintains maximum individual productivity through proficient use of automated systems.

• Personal Development

  • Participates in ongoing independent study and education-related professional activities to maintain and increase knowledge in the areas of Case Management, patient care services, and benefit packages for development of effective case management skills.

  • Demonstrates responsiveness to and appreciation of constructive feedback and recommendations for personal growth and development.

  • Maintains current, active Minnesota nursing licensure.

  • May maintain current, active nursing licensure in other states as assigned.

• Other Duties

  • Willingly…