RN Case Manager - Care Ally - Naperville

Duly Health And Care - Naperville Park District, IL

Full-time - Entry Level

Naperville Park District, IL

Ambulatory Health Care Services

About the position

The RN Case Manager - Care Ally in Naperville is responsible for collaborating with physicians, patients, and families to ensure quality outcomes for patients with complex medical needs. This role involves managing healthcare services, preventing inpatient re-admissions, and addressing the medical, environmental, and psychosocial needs of patients throughout their care continuum. The Case Manager advocates for patients by coordinating care planning and implementing recovery goals while maximizing healthcare benefits.

Responsibilities

• Analyze data collected from predictive modeling tools to identify eligible patients for the Case Management Program.
• Enroll and manage a case load of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements.
• Develop individualized case management plans with prioritized goals and appropriate interventions in compliance with risk stratification level requirements.
• Complete all documentation, member communications, and case closures per policies and procedures.
• Coordinate Health Care Services with appropriate physicians and health care providers.
• Manage and provide a comprehensive summary and log of all active Case Management Cases as required by the UM/QA Committee and/or Health Plan.
• Act as a resource for Utilization Management Staff, physicians, office staff, and Patients.
• Assist with the evaluation and amendment of Case Management Policy and Procedures.
• Attend continuing education sessions and training relating to job functions as required.
• Perform additional duties/tasks as assigned.

Requirements

• Active Registered Nurse License in the State of Illinois in good standing.
• Certification in Case Management (preferred).
• Current CPR certification (BLS) must be maintained.
• Associate's degree in nursing required; Bachelor's degree in nursing preferred.
• 2-4 years of experience working within the primary care or hospital setting as a Registered Nurse.
• Previous experience working within case management (preferred).

Benefits

• Comprehensive medical, dental, and vision benefits including healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider.
• Employer provided life and disability insurance.
• $5,250 Tuition Reimbursement per year.
• Immediate 401(k) match.
• 40 hours paid volunteer time off.
• 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members.