Job Description
Job Description
Description :
TEAM Wellness Corporation is looking for a Nurse Case Manager to provide services to keep patients in the best physical condition by working both proactively and reactively. As a Nurse Case Manager, you will be responsible for overseeing and coordinating short-term and long-term medical care for patients and act as a member of the clinical team. At TEAM Wellness Corporation, we take a holistic approach to understanding client issues and have been providing quality employee assistance program services for members of the building trades for over 30 years.
The position is Monday-Friday, Full Time / In-Office. The Nurse Case Manager’s salary is $75,000 -$90,000 / year, commensurate with education and experience.
Education :
- Bachelor of Science in Nursing (BSN) or Registered Nurse (RN) degree from an accredited college or university required.
Experience :
Experience in medical management, clinical nursing, case or disease management, health benefit plans, health insurance, home care services, or related field is required.Telephone triage or call center background is a bonus.Bilingual in Spanish is a bonus.Essential Job Responsibilities
Provide telephonic, video, and on-site case management for patients with high-acuity and / or co-morbidities.Facilitate access to healthcare providers, benefits information, and health resources.Communicate clear, non-prescriptive messages about medical procedures and timelines to members.Build relationships with members to develop collaborative action plans.Coordinate communication among members, providers, and insurers, ensuring clarity on health questions and plan provisions.Monitor the medical necessity and efficiency of care, collaborating with clinicians and medical directors as needed.Participate in care coordination meetings to address delays and barriers.Uphold TEAM values and continuous quality improvement in all tasks.Stay informed about available benefits, community resources, and coverage information.Maintain continuity of care through communication among patients, families, and providers.Coordinate patient transfers to in-network facilities as appropriate.Keep current with case management practices and relevant policies.Ensure confidentiality of sensitive information.Discuss cases not meeting medical necessity with the care team and clinical director.Serve as a liaison for coordinating care transitions with other agencies.Identify and refer complex cases to supervisors for review.Record, monitor and report data such as clinical outcomes achieved, potentially avoidable and medically necessary variances, length of stay, reviews completed and outcomes, and discharge dispositions daily.Collaborate with care team and attending provider to create actionable care and discharge plans.Assess eligibility, benefits, and ongoing care needs for each case.Function independently and as part of a team, working effectively with various departments, internal and external staff, facilities, clients, clients’ families, and providers to facilitate quality and efficient client care.Provide on-site assessments based on assignment or request.Provide assessments for clients referred on a mandated / formal basis by employers or unions. Solicit perspectives of the referring party as well as the client.Explain benefits and resolve errors with providers and health plans.Complete other assigned duties and projects.The Nurse Case Manager position is an exempt position and includes benefits such as the following :
401(k) and 401(k) MatchingLow Deductible Health and Dental BenefitsLife InsuranceLiability and malpractice insuranceLicense ReimbursementTuition reimbursementEmployee Assistance ProgramFlexible Spending AccountFree ParkingPaid time offLicense / Certification :
RN Minnesota License (Required)Ability to Relocate :
Minneapolis, MN 55435 : Relocate before starting work (Required)Requirements :
