RN Nurse Case Manager (Nursing Facility - Tyler, Texas ( Gregg/Harriso -
|Position Title:||RN Nurse Case Manager (Nursing Facility - Tyler, Texas ( Gregg/Harriso|
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Description of the Position: RN Nurse Case Manager (Nursing Facility - Tyler, Texas ( Gregg/HarrisoCompany: Cigna Careers
Description: Under general supervision, Nursing Facility SC1 will provide field-based case management services for high risk members residing in Nursing Facilities, their families, and physicians in addressing medical and social concerns. Responsibilities will include but are not limited to the following: · develop and implement alternative treatment plans that address individual needs of the member, their benefit plan, and community resources; · Conduct face-to-face initial assessments within 30 days of enrollment in MCO or admission to facility · Conduct face-to-face quarterly visits · Create patient-centered care plans yearly, revise quarterly, and as needed · Discharge planning and coordination · Conduct face-to-face "mini" assessments for members in Hospice twice a year · Monitor Skilled Nursing Facility (SNF) stay and assist with discharge planning · Conduct assessments and coordinate community transitions following the Money Follows the Person program which could include working with NF administrators, coordination of benefits, community home visits to determine home modification needs, and care team meetings · understand and follows policies and procedures and produces and submits reports in a timely manner; · identify members with status changes and notify immediate supervisor for appropriate interventions; · present complex cases during Interdisciplinary Care Team meetings to gain insight from health services leadership, medical directors, pharmacists, co-workers, etc. We are hiring for 3 openings. Ideal candidates must live in one of the following counties: Gregg/Harrison, Smith Cherokee, Nacogdoches/Angelina. Qualifications: Requirements: This position requires a current, unrestricted license in Texas as a Registered Nurse (RN). Three or more years of experience in clinical and case management is preferred. Staff members are required to have access to personal transportation in order to ensure that they are able conduct onsite visits with members within their case load at any given time. Must have an available workspace at home Qualifications: Qualified candidates will possess the following: · knowledge of Medicare and Medicaid healthcare practices and policies · strong time management, organizational, research, analytical, negotiation, and customer service skills · strong written and verbal communication skills in order to effectively communicate with members, physicians, providers and plan leadership · solid computer skills including the ability to document case notes using the case management system. Bilingual skills in Spanish US Candidates Only : Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. If you require a special accommodation, please visit our Careers website or contact us at .
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