RN Complex Case Manager-Hybrid Brazil, Indiana; Counties: Greene, Sullivan, Knox, Clay, Vigo

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Acentra seeks an RN Complex Case Manager in Brazil, Indiana – Hybrid to join our growing team.

The RN Complex Case Manager will:

• Provide in-home, in-person care coordination in defined areas of coal mine states and telephonic care coordination across the United States. An integrated case management model assists the Funds team in maintaining beneficiaries at their most optimal functional level.
• Foster an environment that incorporates the Funds" caring philosophy in all aspects of the case management process and coordinates care with the beneficiary and his/her provider to stabilize health status with the goal of maximizing functional capacity and improving overall quality of life.
• Responsible for assessing, planning, implementing, and evaluating options and services to create an appropriate, individualized plan for the beneficiary across the continuum of care.
• Facilitate, coordinate, integrate, and manage integrated case management and disease management activities based on the CMSA definition, philosophy, and guiding principles for case management.

PLEASE NOTE:

This is a full-time, direct hire, exempt, Hybrid opportunity with Benefits.

The selected candidate is required to reside within a one-hour drive of one of the following Brazil, Indiana, or one of the following Indiana Counties:
Greene, Sullivan, Knox, Clay, and Vigo.

Phone and Travel for In-Home Visits/In-person Care Coordination

• The percentage of In-Home, In-Person Care Coordination visits is up to approximately 25%.
• The percentage of Telephonic Care Delivery across multiple time zones within the U.S. is up to approximately 75%.
• Travel will be to specific counties within Greene, Sullivan, Knox, Clay, and Vigo counties with a drive time distance of up to a one-hour radius maximum (with mileage reimbursement).

Hours: 8:00 AM - 5:00 PM Eastern Monday-Friday.

• Use independent nursing judgment and discretion to address, resolve, and process problems impeding the diagnostic or treatment progress, including medication set-up, blood pressure checks, pulse, temperature, and weight checks to support the home program.
• Seek consultation from physicians, specialists, pharmacists, and other disciplines as necessary to facilitate care to optimize beneficiary function or prevent further decline in health.
• Develop beneficiary-centered care plans demonstrating shared accountability between beneficiaries, caregivers, and providers.
• Coordinate health and social services, coach the beneficiary and families, advocate for the beneficiary, educate the beneficiary and family, clarify, and assist with physician care plans, and communicate status and plans among the care team and resources, as indicated.
• Conduct visits in the beneficiary's home. Visits to hospitals, nursing homes, and physicians' offices as necessary to continue the plan of care and support transition.
• Review the care plan and progress in regular care conferences, emphasize transitions to other programs, and teach self-management/family caregiver management of chronic conditions to optimize functions, improve health, prevent further decline, or remain in the community.
• Ensure day-to-day processes are conducted in accordance with the Utilization Review Accreditation Commission (URAC) and other regulatory standards.

The above list of responsibilities is not intended to be all-inclusive. It may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Required Qualifications /

Experience:

• Unrestricted, active RN compact state license.
• High School diploma or GED equivalent.
• 3+ years of clinical experience with 1+ years of case management experience.
• Must be proficient in Microsoft Office, Internet/Web Navigation, and research.
• Must be proficient in the use of electronic medical record systems/electronic documentation and navigating multiple computer systems and applications.
• Ability to perform a basic physiological assessment that does not require a physician order, temperature, pulse, blood pressure, weight, and visual skin assessment.

Preferred Qualifications /

Experience:

• Bachelor of Science in Nursing (BSN) (or higher level of education).
• Public Health Nursing experience and geriatric nursing care.
• Certified Case Manager (CCM).
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making.
• Demonstrated initiative and judgment in performing job responsibilities while maintaining professionalism, flexibility, and dependability under pressure.
• Strong communication (written/verbal), interpersonal, organizational, time management, and communication skills with a strong focus on customer service, including building and…