Job ID 126622
RN Case Manager (Remote within Oregon + potential travel) Job Description
Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.
RN Case Manager (Remote within Oregon + potential travel)
- Are you an experienced RN Case Manager looking for a new challenge?
- Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?
If so, you might be our next new team member!
** This is a full-time, direct hire, exempt (salary), Remote opportunity with Benefits. **
** The selected candidate must reside in the state of Oregon. **
** This role may require Travel in the future, including reliable transportation and a valid unrestricted driver’s license. **
** Positions are available in one of the following four (4) Service Areas/Regions where you must also reside. Please select the Service Area where you reside:
Service Areas (Regions):
- Klamath Falls, Lakeview, Bend, Burns, Jordan Valley.
- Portland, Gresham, Beaverton, Salem, Tillamook, Seaside, Newport, Albany, Florence, Springfield.
- Ontario, Baker City, La Grande, Pendleton, The Dalles, Canyon City.
- Eugene, Florence, North Bend, Coos Bay, Roseburg, Redmond, Brookings, Medford, Ashland.
** The primary COVID-19 vaccination is required as you will work with beneficiaries in person.
** This position is contingent upon the award of a Request for Proposal (RFP). **
Who we need:
The RN Case Manager will:
- Provide telephonic care coordination in the state of Oregon from a remote setting. An integrated care management model is used (includes care coordination/case management and disease management) to assist the Health-Related Social Needs (HRSN) program.
- Foster an environment that incorporates all aspects of the care management process and coordinates care with the beneficiary to stabilize their health status with the goal of maximizing their functional capacity and improving overall quality of life.
- Be responsible for assessing, planning, implementing, and evaluating options and services to affect 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.
- Provide comprehensive assessments and periodic reassessment of individual needs, to determine that need for any medical, education, social, or other services.
- Provide communication activities including but not limited to, weekly meetings, telephone interactions, caregiver interactions, rounds, interdisciplinary team meetings, and other related evidence-based practices.
- Coordinate referrals and related activities (such as scheduling appointments for the individual) to help the eligible individual obtain needed services.
- Ensure quality-driven outcomes through best practices and motivational interviewing. Assure accuracy and timeliness of all applicable review-type cases within contract requirements.
- Always maintain medical records confidentiality through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
Singularly Focused. Mission Driven.
Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.
We do this through our people.
You will have meaningful work that genuinely improves people’s lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.
What you’ll do:
- Use independent nursing judgment and discretion to address, resolve, and process problems impeding the treatment plan
- Seek consultation from community 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’s care plans, and communicate status, and plans among the care team and resources, as indicated.
- 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 URAC and other regulatory standards.
The above list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.
What you’ll need:
Required Qualifications / Experience
- A resident of Oregon.
- Unrestricted, active RN License in Oregon (or Compact State license).
- 3+ years of clinical experience
- 1+ years of case management, disease management, or complex care coordination.
- Reliable transportation and valid unrestricted driver’s license, for potential future Travel within Oregon.
Preferred Qualifications / Experience
- Bachelor of Science in Nursing (BSN).
- Public Health Nursing and Geriatric Nursing Care experience.
- Certified Case Manager (CCM).
- Some field-based work or telephonic case management experience.
- Experience with Utilization Review Accreditation Commission (URAC) guidelines.
- Knowledge of medical technology.
- Proficiency with MS Office Suite.
Required Knowledge, Skills, Abilities
- Proficient in Internet/Web Navigation and research.
- Proficient in the use of electronic medical record systems/electronic documentation and navigating multiple computer systems and applications.
- Maintain competency in conducting a variety of physiological assessments.
Preferred Knowledge, Skills, Abilities
- 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 the performance of 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 maintaining relationships with internal/external customers and facilitating meetings.
- Ability to work independently and as part of a team.
- Ability to research/identify and apply appropriate standards of care.
- Interest in continuous learning and a commitment to staying informed on regulatory changes.
We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!
~ The Acentra Health Talent Acquisition Team
EOE AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.
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