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Position:

RN Field Case Manager (Hybrid)

Position Summary:

Provides in-home assessments, telephonic care, and case management to Medicare members as part of a multidisciplinary care team. Offers members health and disease education and empowers them to participate in their care. Assesses clinical and social needs, collaborates with care team, provides timely skilled nursing in the home as needed.

Job Description:

Primary Responsibilities

• Works cross-functionally with providers and a multi-disciplinary care team. Collaborates with the care team and is the first level of licensed escalation to provide quality services to the patient.
• Fosters relationships & establishes trust with patients, family members, and care teams.
• Answers clinical questions through phone calls. Makes outbound calls to assess and triage member's current health status.
• Uses best practices to resolve patient needs as appropriate or to prep message for provider that contains all necessary information.
• Conducts in-home assessments of functional abilities and environmental needs. Administers medications and treatments prescribed by physicians (e.g., blood draws, IC antibiotics, IV fluids, wound care, etc.).
• Provides patient education to assist with self-management. Educates members on disease processes, and encourages members to make healthy lifestyle changes.
• Documents and tracks findings in a computerized system.
• Reviews member care plans and collaborates with providers to ensure there are no gaps in care.
• Identifies gaps or barriers in treatment plans.
• Coordinates care for members including services such as home health and Durable Medical Equipment (DME), as needed.
• Recommends referrals to outside sources. Connects members to community resources.
• Provides consultation on member medications and DME.
• Collaborates with members, providers, and care givers to ensure positive care outcomes during care transitions. Serves as liaison for patients between health plans, government & community programs, providers, and family.
• Ensures that discharged members receive the necessary services and resources, including medication reconciliation.
• Partners with medical management team members in development of new programs.

Qualifications

• Current licensure in good standing as a registered nurse in the state of Missouri and Illinois and eligibility for licensure in other states
• 5+ years of relevant experience or the knowledge, skill, or ability to succeed in the role
• Solid computer skills with the ability to type and talk simultaneously
• Excellent interpersonal and customer service skills, including telephone etiquette
• Ability to multi-task, prioritize, and adapt to a changing environment
• Travel greater than 50% of the time to member homes for in-home assessments

Preferred:

• 2+ years’ experience in a hospital or home health case management setting

Disclaimer

• The job description describes the general nature and level of work being performed by people assigned to this job and is not intended to be an exhaustive list of all responsibilities, duties and skills required. The physical activities, demands and working conditions represent those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties and responsibilities.

Lumeris is an EEO/AA employer M/F/V/D.

The hiring range for this position is:

$72,800.00-$97,400.00

Factors that may be used to determine your actual pay rate include your specific skills, experience, qualifications, location, and comparison to other employees already in this role. This role may also be eligible for incentive compensation. At Lumeris, we are committed to providing a total rewards package that supports your overall well-being. Our benefits include medical, vision, dental, well-being programs, 401(k) with company matching, life insurance, paid time off including paid leave, and so much more. Learn more by visiting our Careers Page.

Member Facing Position:

Yes- Member Facing Position

Location:

Illinois

Time Type:

Full time

Lumeris and its partners are committed to protecting our high-risk members & prospects when conducting business in-person. All personnel who interact with at-risk members or prospects are required to have completed, at a minimum, the initial series of an approved COVID-19 vaccine. If this role has been identified as member-facing, proof of vaccination will be required as a condition of employment.