Case Management RN Lead

CNSI and Kepro are now Acentra Health! 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.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Case Management RN Lead to join our growing team.

Job Summary:

The Case Manager, RN Lead, will support and contribute to enhancing the company’s success through support of the case management function, acing a first level touchpoint for case manager questions, issues, system discrepancies, and escalations. The goal is to support personalized care planning, member outreach, caseload management, compliance and optimized outcomes.  outcomes and compliance with payer standards. This will require collaboration with healthcare team members to strengthen the overall effectiveness of care delivery, while their expertise in coordinating diverse beneficiary needs and contract deliverables. This role will continue to work as a case manager with a case load, but will be mentored to support individual team mates. 

*Position is remote within the United States. Candidates in Oregon are preferred.  

Job Responsibilities: 

• Resolve issues and escalations specific to case manager concerns with members and community interactions, recognizing when to involve manager or other leadership versus immediate resolution
• Ability to quickly recognize and categorize issues for resolution and appropriate next steps
• Become expert in OARs governing contract and case management services in the state of OR
• Comprehensive understanding of the case management program standards, deliverables, goals, and outcomes
• Ability to assist in system issues or barriers during outages or other service disruptions
• Ability to mentor colleagues and lead by example for optimized individual and team performance
• Backup for Supervisor or Manager for operational functions that do not involve direct employee supervision or management
• In addition to all of the case manager requirements below, the above requirements are key for this Lead role.
• Provide care coordination/care management for beneficiaries, ensuring a high level of clinical knowledge and performance by the clinical team. 
• Foster a caring philosophy in leadership and all aspects of the care management process.
• Manage the care of beneficiaries through the healthcare system based on their individual needs.
• Use independent judgment and discretion to address and proactively resolve barriers impeding diagnostic or treatment progress.
• Interact and collaborate with a multidisciplinary care team, including physicians, nurses, case managers, pharmacists, and social workers/educators to ensure beneficiary needs and preferences for health services/information are shared. 
• Educate beneficiaries about community resources/options and advocate on behalf of the beneficiary.
• Establish a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality outcomes.
• Maintain open communication with all appropriate parties.
• Maintain strict standards for client confidentiality and client-related information. Comply with all organizational, state, and federal regulations and policies on confidentiality.
• Prepare documentation, status updates, event notifications, and other documentation regardingbeneficiaries in accordance with regulatory requirements and company policies and procedures.
• Monitor case load to ensure all required documentation and entry of assessment results into a web-based database are completed accurately and promptly.
• Pursue ongoing education, certification, and self-development to remain current with case management standards and pursue CCM certification.
• Other duties as assigned.

Requirements

Required Qualifications/Experience:

• Bachelors of Science in Nursing.
• 3+ years clinical experience.
• Oregon RN License.

Preferred Qualifications/Experience:

• Preferred Oregon resident.
• 1+ years case management or home care experience.
• Certified Case Manager (CCM) preferred.
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines.
• Superior attention to detail.
• Demonstrated ability in decision-making. 
• Demonstrated initiative and judgment in performance of job responsibilities.
• Maintain professionalism, flexibility and dependability under pressure. 
• Strong communication (written/verbal), interpersonal, organizational, time management and communication skills.
• Exceptional customer service skills.
• Ability to foster 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.

Why us?

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.

We do this through our people. 

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.

Thank You!

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 interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

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.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide additional protection, security, and support for your career and life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.  

Compensation

The pay range for this position is $61,200-88,000.

“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”