Nurse Case Manager – NICU, Bilingual Spanish
ProgenyHealth, LLC
full-time
Posted on:
Location Type: Remote
Location: United States
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About the role
- The Case Manager will focus on empowering the members’ family to support optimal wellness while advocating for the necessary medical services across the health care continuum.
- Works in a telephonic managed care setting combining strong clinical knowledge and critical thinking to facilitate a plan of care that will ensure quality medical care for the high-risk member population serviced by ProgenyHealth based on the CMSA national standards for case management practice.
- Assesses the physical, functional, psychological, environmental, educational, and financial needs of members referred to the Case Management program.
- Completes needs assessments for all members in CM and develops care plans individualized to the needs of each member as per ProgenyHealth policies and procedures.
- Assigns risk stratification based on complexity of medical and social needs and determines ongoing frequency of calls to continually assess plan of care.
- Monitors the care plan to ensure effective, appropriate provision of services and adequacy of benefits.
- Interfaces with providers to assist with care coordination activities, which can include appointments, transportation, DME, etc.
- Provides education to members regarding condition, treatment plan, benefits, services, and how to access needed care.
- Monitors ongoing progress towards goal achievement and reassess changes in health status throughout continuum of care.
- Provides referrals to appropriate community resources; facilitates access and communication when multiple services are involved; monitors activities to ensure that services are actually being delivered and meeting the needs of the member.
- Participates in interdisciplinary and client rounds with pertinent health care team members to identify, clarify, and/or prevent risk, quality, or plan of care variances.
Requirements
- Must be bilingual in Spanish.
- Registered Nurse (RN) with a current, unrestricted license is required.
- College degree is preferred.
- Experience in a Case Management role is preferred.
- Three (3) or more years of clinical experience in a Level III or above NICU is required.
- CCM certification required within the timeframe specified by company policy.
- Experience with data entry into a database or EHR required.
- Must be computer literate.
- Excellent communication skills and organizational ability are required.
- Must be self-motivated and willing to learn multiple tasks.
- Must be well organized and able to prioritize tasks.
- Must demonstrate accuracy in spelling and documentation.
- Demonstrated strength in working independently as well as collaboratively within a team.
- Must have excellent interpersonal skills, telephone etiquette, and maintain positive communication at all times.
- Must have commitment to excellence in customer service.
Benefits
- Paid Time Off
- Paid Parental Leave
- Medical, dental, vision benefits
- 401K with company match
- Short- and Long-Term Disability
- Group Life Insurance
- Tuition reimbursement
- Professional development opportunities
- Business Casual work environment
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
case managementclinical experiencedata entryEHRneeds assessmentcare plan developmentrisk stratificationcare coordinationmonitoring progressreferrals to community resources
Soft Skills
bilingual in Spanishexcellent communication skillsorganizational abilityself-motivatedability to prioritize tasksaccuracy in documentationindependent workcollaborative teamworkinterpersonal skillscustomer service commitment
Certifications
Registered Nurse (RN)CCM certification