RN Case Manager

About This Role

The Case Manager will support patients, families, and physicians by addressing medical and social concerns, educating them on healthcare decisions, and facilitating communication among all parties. This role involves integrating clinical and psychosocial information to develop action-oriented care plans and ensuring compliance with regulations.

Responsibilities

• Ensure all activities are member-focused and individualized to meet unique patient needs.
• Identify interventions and resources to help members achieve personal health-related goals.
• Integrate clinical and psychosocial information for case identification and patient assessment to develop action-oriented plans.
• Facilitate effective communication between patients, families, providers, health plan, and community-based services.
• Coordinate service coverage with appropriate funding sources.
• Effectively communicate with patients and families to enhance their understanding of health, benefits, and the healthcare system.
• Maintain current and accurate documentation and case management files.
• Establish and maintain good working relationships within the Case Management department and with other HealthPartners departments.
• Support other team members in achieving patient-centered goals.
• Maintain knowledge of and effectively use automated applications and systems.

Requirements

• Current unrestricted Registered Nurse license in Minnesota
• 3+ years clinical practice experience in acute care
• 3+ years utilization review, discharge planning, or case management experience
• Demonstrated effective, independent nursing judgment and skills
• Expertise in written, oral and interpersonal communication
• Demonstrated skill in effective use and management of automated medical management systems
• Basic computer skills

Qualifications

• Registered Nurse with BSN preferred
• Minimum of 3 years clinical practice experience in an acute care setting; minimum of 3 years relevant utilization review, discharge planning, or case management experience; and current clinical knowledge.

Nice to Have

• BSN
• Current active nursing licensure in other states as assigned
• Working knowledge of quality improvement, utilization management, benefit plans, fiscal management, and various payment methodologies
• Understanding of healthcare and/or HMO industry

Benefits