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Case Manager - RN (Must reside in Nashville, TN area) at Keystone Peer Review Organization, Inc. in Nashville, Tennessee

Posted in Nurse 27 days ago.

Type: Full-Time





Job Description:

Case Manager - RN


 



  • Are you an experienced Case Manager looking for a new challenge?

  • Do you value care management?

  • Are you motivated, energetic, and excited to become part of the Kepro team?

 


If so, you might be our next new team member!



Who we need: 


The Case Manager is responsible for assessing, planning, implementing, monitoring and evaluating options and services to effect an appropriate, individualized plan for the beneficiary across the continuum of care. Using independent judgment, the Case Manager utilizes clinical knowledge and competence, communication skills, problem solving and conflict resolution to effectively ensure optimal client outcomes with consideration to payer requirements. This position also coordinates beneficiary needs related to community resources, financial assistance programs, and long-term activity of daily living needs outside the benefit criteria of the medical insurance coverage. The Case Manager will work effectively with all health care team members internally and externally. 


Why us?


Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. 



People Focused. Mission Driven. 


Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.


We do this through our people.


At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.


Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.



What you’ll do: 



  • Provide care coordination/care management beneficiaries; assures a high level of clinical knowledge and performance by the clinical team.   Foster a caring philosophy in leadership and all aspects of care management process.

  • Manage care of beneficiaries through the health care system based on the individual needs of the beneficiary.

  • Use independent judgment and discretion to address and proactively resolve barriers impeding the diagnostic or treatment progress. 

  • Interact and collaborate with multidisciplinary care team, which includes physicians, nurses, case managers, pharmacists and social workers/educators to ensure beneficiary needs and preferences for health services/information is shared; educates beneficiaries about community resources/options; advocates 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.  Complies with all organizational, state and federal regulations and policies on confidentiality. 

  • Prepare documentation, status updates, event notifications and other documentation regarding beneficiaries in accordance with regulatory requirements and company policies and procedures.

  • Monitor case load to ensure all required documentation and entry of assessment results into web-based database are completed accurately and timely.

  • Pursue ongoing education, certification, and self-development to remain current with case management standards.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.



What you’ll need: 


 


Qualifications



  • Current, unrestricted RN License license in a state or territory of the United States that allows the health professional to independently conduct an assessment as permitted within the scope of practice of the discipline.

  • BSN and/or CCM preferred.

Knowledge, Skills, Abilities 



  • Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making.

  • Demonstrated initiative and judgment in performance of job responsibilities, while maintaining professionalism, flexibility and dependability under pressure.

  • Strong communication (written/verbal), interpersonal, organizational, time management and communication skills with a strong focus on customer service, including building and maintaining 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.

Experience 



  • 3 - 5 years clinical experience, required with a minimum of 1-3 years case management or home care experience preferred.

 


Thank You! 


We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!


~ The Kepro Talent Acquisition Team


 


Mental and Physical Requirements               


The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.


Kepro offers challenging careers, excellent benefits and opportunities for advancement.  For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.  Visit our website at www.Kepro.com for more information on the Kepro Family of Companies.   


EOE AA M/F/Vet/Disability


Kepro 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, or status as a protected veteran.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)

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