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Registered Nurse - Case Manager

Company: TotalMed
Location: Wheaton
Posted on: May 1, 2021

Job Description:

Location: Cook County and Collar Counties (Lake, Kane, DuPage, Will)

Majority of position is performed telephonically; however, up to 50% local travel is required

Pay: $30 - $37 per hour

Hours: M-F 8am-5pm

Qualifications: RN License in Illinois



The Case Manager (CM) is a health care professional who is responsible for assessing an individuals health status and care management needs, actively engaging and connecting that individual to sustaining health care. The CM assesses, creates plans of care, organizes, coordinates, monitors, and evaluates options and services to meet an individuals physical and behavioral health care needs. The CM has a propensity for compassion and an ability to relate to individuals varying needs. The CM motivates impact and serves as an advocate and champion for the individual client-members health outcomes while improving care, driving quality, and decreasing health care costs.



- Conduct telephonic and/or face to face outreach to client-members, payor, providers, social and community support systems and agencies; building relationships

 - Complete health risk screenings, health risk assessments, applicable clinical assessments, and make appropriate recommendations for services and level of care based on assessment findings and clinical judgement

- Develop and monitor integrated care plans based on the assessment, in collaboration with the client-member, guardian, and other members of the treatment team, with specific goals and interventions designed to meet the client-members needs and promote desired outcomes

- Conduct transition of care outreach and follow up, including but not limited to inpatient hospital discharge outreach, and post-discharge follow up to assure continuity of care and prevent non-medically necessary readmissions

- Facilitate referrals made to providers, community-based organizations, and other supportive services

- Coordinate services between the Primary Care Physician (PCP), specialists, behavioral health providers, community agencies, and social and community support systems necessary to meet the client-members clinical needs and for the continuation of care

- Uses motivational interviewing to educate, support, and motivate change during client-member interactions

- Review medical records and application of pertinent findings; monitor medication compliance

- Actively participate in interdisciplinary care team meetings and case rounds with internal and external stakeholders

- Collaborate with the interdisciplinary team members to assure the integration of care and provide consultation, resources, and recommendations to peers as needed

 - Document all activities and interactions in the client-members electronic health record

- Maintain assigned caseload using tools and resources provided to ensure compliance with quality and program criteria

- Identify and report Fraud, Waste and Abuse/Abuse, Neglect and Exploitation or any Quality of Care concerns

- Actively engage care management team and work on special projects related to care management as needed


Minimum Requirements

- 2 years of clinical experience in a home health, hospital or other healthcare setting

- 2 years of experience with patient care plan

- Active RN, LPN, Licensed Social worker IL License required

- Previous case management experience preferred

Keywords: TotalMed, Wheaton , Registered Nurse - Case Manager, Other , Wheaton, Illinois

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