Population Health Intensive Case Manager (RN)

York, PA | Professional | Tracking Code: 68895

 

Full time (80 hours biweekly)

Monday - Friday

Day shift

Job Description:

RN Under general supervision, the Population Health Intensive Case Manager (ICM) coordinates and monitors the health needs of members, such as pain, symptom management, behavioral health, DME’s, home health, assistance with daily living, and/or community resources. Conducts comprehensive assessments that include the medical, behavioral, pharmaceutical, and social needs of the patient, identifying gaps in care and barriers to attaining improved health. The ICM works closely with members, caregivers, family members, physicians, ambulatory care managers, hospital care managers, and ancillary service providers to achieve the member’s maximum functional potential. This position provides on-going support through comprehensive assessment and care planning. The ICM ensures member’s cases are in compliance with regulatory guidelines.

 

Duties and Responsibilities

 

  1. Utilize Motivational Interviewing techniques as a member-centered approach to activate members in self-management of their chronic conditions with the goal of improved symptom management and interruption of a negative disease trajectory.
  2. Maintain a caseload of members according to department policies.
  3. Identify, enroll and manage members in program for SNP, Complex Case Management/Chronic Disease Management.
  4. Develop and implement care plans to maximize healthcare outcomes and facilitate wellness with periodic review and update according to department protocols.
  5. Perform medication review and teach-back to ensure member understanding and ability to adhere to medical regimen.
  6. Collaborate with PCPs, Specialists, and Hospitalists to effectively implement a member-centered care plan.
  7. Perform member outreach according to established protocols and document in electronic medical record.
  8. Identify, execute, and track needed referrals to care and community resources.
  9. Provide resource management to improve care, member experience and reduce unnecessary cost and utilization: right care, right place, right time.
  10. Assist member in advanced care planning to complete Advanced Directives.
  11. Documents member’s assessments, care plans, goals and interventions in electronic medical management system according to NCQA standards.
 

 

 

Qualifications

 

  • Minimum Experience:
    • 3 - 5 years
  • Minimum Education:
    • Bachelor's Degree
  • Preferred Field Of Expertise:
    • Utilization management, case management, or clinical nursing specialty
  • Required Certification:
    • Registration and current RN license in PA
Heather Torres
Heather Torres
Sr. Talent Acquisition Consultant
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Why WellSpan Health?

WellSpan Health is an integrated health system that serves the communities of central Pennsylvania and northern Maryland. The organization comprises a multispecialty medical group of more than 1,600 physicians and advanced practice providers, a regional behavioral health organization, a home care organization, eight respected hospitals, more than 20,000 employees and 200 patient care locations. WellSpan is a charitable, mission-driven organization committed to exceptional care for all, lifelong wellness and healthy communities. We are committed to transforming the health of the communities we serve and to educating the next generation of clinicians, staff and leaders.

Employment Benefits

  • Sign-on incentives for new employees (click here for details)
  • Medical, dental and vision insurance
  • Life and accidental death insurance
  • Supplemental life insurance
  • Retirement savings plan
  • Paid time off (PTO)
  • PTO bridging
  • Short-term disability
  • Educational assistance
  • Forgivable loan
  • Flexible spending
  • Credit union
  • Employee recreational activities
  • Childcare
  • Complimentary medicine discounts

Diversity & Inclusion

Welcome. Respect. Value.

Wellspan Health believes that diversity includes all the human characteristics that make each of us similar as well as different. We strive to make every person feel welcomed, respected, and valued while creating a safe and inclusive environment where we all have the individual freedom to express our uniqueness in a respectful manner.

WellSpan Health is an equal opportunity employer. Employment selection and related decisions are made without regard to sex, race, age, disability, religion, national origin, color or any other protected class. WellSpan Health does, however, have a tobacco-free/nicotine-free hiring policy.

Quality of Life

Founded in 1741, the city of York is considered by many as the first capital of the United States. The Articles of Confederation were signed by the Second Continental Congress here in 1777. Its beautifully restored historic district is an architectural treasure. While York retains its farming and manufacturing heritage, at its heart York is a thriving cultural community that has attracted creative talent and innovative entrepreneurial investors from across the nation.

Life in York County offers affordable housing, options for higher education, a thriving arts and cultural community, historical attractions, parks and recreational resources, semi-professional baseball team, fine dining and more — within an easy drive of major East Coast cities.

York County residents can find local employment in healthcare, manufacturing, technology, agricultural and service sectors. (Patient population: 445,000)