RN Care Ally-Tinley Park

Benefits

• Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance
• Free mental health benefit
• Employer‑provided life and disability insurance
• $5,250 tuition reimbursement per year
• Immediate 401(k) match
• 40 hours of paid volunteer time off
• Culture committed to community engagement and social impact
• Up to 12 weeks of parental leave at 100% pay and financial benefits for adoption and surrogacy for non‑physician team members upon meeting eligibility requirements

• Collaborate with physicians, patients, and families to promote quality outcomes for patients with complex medical needs
• Increase efficient utilization of health care services; identify chronic or catastrophic cases through the case management process and initiate intensive case management according to program guidelines
• Manage patients in all health care settings to assure appropriate level‑of‑care, prevent inpatient re‑admissions, and meet patients’ medical, environmental, and psychosocial needs across the continuum of care
• Act as an advocate by coordinating and communicating with the health care team and family regarding care planning and implementation of recovery goals
• Assess and coordinate resources available to patients and maximize the use of health care benefits
• Analyze data collected from predictive modeling tools to identify eligible patients for the Case Management Program
• Enroll and manage a case load of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements
• Develop individualized case management plans with prioritized goals and appropriate interventions in compliance with risk stratification level requirements
• Complete all documentation, member communications, and case closures per policies and procedures
• Maintain proficiency in current Case Management Standards
• Coordinate health care services with appropriate physicians and health care providers
• Maintain a comprehensive summary and log of all active Case Management cases as required by the UM/QA Committee and/or Health Plan
• Serve as a resource for Utilization Management staff, physicians, office staff, and patients
• Assist with the evaluation and amendment of Case Management policy and procedures
• Attend continuing education sessions and training related to the job functions as required
• Perform additional duties or tasks as assigned

• Active Registered Nurse License in the State of Illinois in good standing
• Certification in Case Management preferred
• Current CPR (BLS) certification required
• Associate’s degree in nursing required;
  Bachelor’s degree in nursing preferred
• 2–4 years of experience as a Registered Nurse in a primary care or hospital setting
• Previous case management experience preferred
• Compensation range: base pay $67,000–$101,000, with additional shift differentials, bonuses, and other incentives

Compensation is determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Base pay is only a portion of the total rewards package.