RN Case Manager, Health Plan – SD/ND Position Available In Dauphin, Pennsylvania

Job Description:

Careers With Purpose Sanford Health is one of the largest andfastest-growing not-for-profit health systems in the United States.

We’re proud to offer many development and advancement opportunitiesto our nearly 50,000 members of the Sanford Family who arededicated to the work of health and healing across our broadfootprint.

Facility:

Fargo Health Plan Location:

Fargo, ND Address:

1749 38th St S, Fargo, ND 58103,

USA Shift:

Day Job Schedule:

Fulltime Weekly Hours:

40.00

Salary Range:

$29.00 – $46.50 DepartmentDetails Looking for a registered nurse to join our Care TransitionsCase Management Team. Day position with no weekends or holidays.

Option to work remotely after 6 months. Job Summary The casemanager provides case management and care coordination fordesignated Health Plan members. Develops a care plan that includesmanaging and directing members to appropriate resources, servicesand programs. Evaluates for comprehensive coordination of care andhealth services to manage members across the continuum, createsaction plans for members and helps them track toward programgraduation. Collaborates with the integrated team and partners inorder to provide a seamless exchange of information betweenproviders, members and caregivers with the ultimate outcome toimprove quality, reduce costs and enhance the member experience.

Conducts member assessments, identifies gaps and interventions, andcoordinates ongoing care with physician and integrated team.

Coordinate with facilities to assist with discharge planning,aftercare follow-up appointments and transition of care asappropriate. Coordinates and manages medical/behavioral healthneeds of members across the continuum of care. May performauthorizations for services as indicated for specialty casemanagement. Provides educational resources to member based onmedical and behavioral health needs. Serve as a consult on casesfor their clinical expertise when they are not the lead casemanager. Supports a successful self-management of their long-termhealth status. Uses internal and external resources to providequality and cost-efficiency care. Utilizes motivational techniquesto promote member engagement. Possesses strong clinical knowledgeand skills. Collaborates with team members both internally andexternally to ensure care is coordinated and appropriate based onevidence based medicine. Must be self-motivated with the ability towork independently, a problem solver and fiscally responsible.

Ability to work independently or as a member of a team. Ability tomultitask and work with little direction. Works primarily dayhours. Works primarily telephonically in an office environment andonsite as needed. Travel may be required as necessary.

Qualifications Depending on area of focus, education, experienceand licensure differs. Bachelor’s degree in nursing required.

Graduate from a nationally accredited nursing program preferred,including, but not limited to, Commission on Collegiate NursingEducation (CCNE). Accreditation Commission for Education in Nursing(ACEN), and National League for Nursing Commission for NursingEducation Accreditation (NLN CNEA) is strongly preferred. ORMaster’s degree in counseling, social work, marriage and familytherapy or psychology required. Graduate from a nationallyaccredited behavioral health program. Accreditation from (CACREP)Council for Accreditation of Counseling and Related Educationalprograms. Accreditation from (COAMFTE) Commission on Accreditationfor Marriage and Family Therapy Education, or (CSWE) Council ofSocial Worker Education.

Nursing:

Will consider applicant withsignificant background in case management, transplant servicesand/or other utilization review experience. Minimum of three yearsnursing experience is required.

Behavioral Health:

Will considerapplicant with significant background in case management orspecialized clinical experience. Minimum of five years behavioralhealth experience is required. Must have knowledge of Diagnosticand Statistical Manual of Mental Disorders (DSM) V, and AmericanSociety of Addiction Medicine (ASAM) criteria.

Nursing:

Currentlylicensed with the applicable state nursing board and/or possessmultistate licensure privileges as required by position. CurrentCommission for Case Manager Certification (CCMC) is preferred or isto be obtained within two years of employment.

Behavioral Health:

Currently licensed with the applicable behavioral health board orappropriate regulatory board and/or possess multistate licensureprivileges as required by position. Benefits Sanford Health offersan attractive benefits package for qualifying full-time andpart-time employees. Depending on eligibility, a variety ofbenefits include health insurance, dental insurance, visioninsurance, life insurance, a 401(k) retirement plan, work/lifebalance benefits, and a generous time off package to maintain ahealthy home-work balance. For more information about TotalRewards, visit https://sanfordcareers.com/benefits . Sanford is anEEO/AA Employer M/F/Disability/Vet. If you are an individual with adisability and would like to request an accommodation for help withyour online application, please call 1-877-673-0854 or send anemail to talent@sanfordhealth.org . Sanford Health has a Drug FreeWorkplace Policy. An accepted offer will require a drug screen andpre-employment background screening as a condition of employment.

Req Number:

R-0225500

Job Function:

Health Plan Featured:

No