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Behavioral Health Case Manager RN - Florida (REMOTE)
Information Technology company
Information Technology company
Jacksonville, FL 32256
W-2 onlyContract3382 views
Jacksonville, FL 32256
Contract
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Your Recruiter
Erika Soniega
Technical Recruiter
This posting is no longer accepting new applicants

Seeking a Case Manager RN for a 100% Remote position but must reside in Florida.

A multidisciplinary approach is required for addressing the growing complex needs of an aging Medicare population. This position will support members with mental illness who are at risk or have high rates of behavioral health utilization and/or psychosocial vulnerability. The RN Behavioral Health Case Manager provides support and/or intervention and assists members in understanding the implications and complexities of their current behavioral and medical conditions. Utilizing a member-centric approach, they assist members and their families in coordinating care: reinforcing the physician’s treatment plan, medication management, and providing education and tools to promote self-management to improve health outcomes and reduce overall costs. Individual care plans are developed in collaboration with the Physician, Member/Care Giver, Families and the Care Team. Ongoing coaching, monitoring and evaluation of care plans will be done telephonically or electronically through email and member and provider portals. The position also assists those who have maximized their Medicare benefits.

Responsibilities

  • The essential functions listed represent the major duties of this role, additional duties may be assigned.
  • Engage Members telephonically to identify high risk behavioral health needs for nurse case management intervention and coordinating the delivery of cost-effective, quality-based behavioral health care services. With a member-centric approach, develops and implements alternative treatment plans that address individual needs. Facilitates access to care.
  • Facilitate care for high risk behavioral health members across the continuum of the health care experience, including care transitions, coordination of community and social service and coordinating with other value-based organizations, providers as needed.
  • Plan, implement, coordinate and monitor Case Management activities that may include acute and non-acute services and outpatient services. Monitors and evaluates effectiveness of care plan and modifies plan as needed. Supports member access to appropriate quality and cost effective care.
  • Close gaps in care
  • Conduct Medication Reconciliation and promotes compliance with treatment plan
  • Collaborate with Member, Member’s Physicians, Plan Medical Directors, Managers, Local, Regional and Specialty team members as well as other functional areas to assist the member to meet their health care goals.
  • Promote healthy lifestyles, assist in strengthening the patient-physician relationship, encourage behavior and lifestyle changes to realize a better quality of life, for individuals with identified with behavioral health conditions.
  • Assist Members and their physicians to navigate through the health continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access.
  • Facilitate and document interdisciplinary care team meetings for at risk members as appropriate.

Requirements

  • Florida RN License
  • 3+ years related work experience 1+ year Behavioral / Psychiatric Nursing
  • Hands on with members on the phone: - bipolar, depression, anxiety, (Need to be very comfortable with patients over the phone)
  • Assigning care plans to behavioral health patients & de-escalating
  • Experience with Medicare population and assisting in assigning care
  • Experience with influencing and motivating individuals to change health behaviors
  • Knowledge and/or experience with population health
  • Experience in two or more of the following: home health care, utilization review, discharge planning,
  • Experience working with Managed Care products, benefits and services
  • Experience in planning, implementing coordinating and monitoring activities that focus on acute and non-acute behavioral health services, outpatient services and/or community resources
  • Basic to intermediate experience in MS Word, Excel, tablet and/or smartphone
  • Travel up to 30% (subject to change) for on-site member/provider/employer meetings, events or manager requests with occasional overnight stays
  • Must have valid driver's license and reliable transportation
  • Telephonic Case Management Experience
  • Bilingual English/Spanish (nice to have)


Required Education:

  • Nursing - Related Bachelor's degree required
  • Case Management Certification (CCM) - Preferred
  • Psychiatric Nurse Certification (nice to have)

Skills
Skill Proficiency Years Experience Percent Used
Case Management
Any100%
Nursing
1 - 3100%
Registered Nurse
Any100%
Medicare
Any75%
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