Remote Program Manager Jobs in Macomb, MI (NOW HIRING)

Long-term contract with potential to be contract to hire: Fully remote, but must reside in MI. CCM is required, along with RN:

ESSENTIAL DUTIES AND RESPONSIBILITIES

·       The Case Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs.

·       They serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the online messaging platform.

·       The Case Manager RN uses the case management process to assess, develop, implement, monitor, and evaluate care plans designed to optimize the member’s health across the care continuum.

·       They work in partnership with the member, providers of care and community resources to develop and implement the plan of care and achieve stated goals.

·       Other duties may be assigned:

o   Lead the coordination of a regionally aligned, multidisciplinary team to provide holistic care to meet member needs telephonic and/or digitally.

o   The multidisciplinary team is inclusive of Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff and Medical Directors.

o   Assess the member's health, psychosocial needs, cultural preferences, and support systems.

o   Engage the member and/or caregiver to develop an individualized plan of care, address barriers, identify gaps in care, and promotes improved overall health outcomes.

o   Arrange resources necessary to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services and disease-specific services).

o   Coordinate care delivery and support among member support systems, including providers, community-based agencies, and family.

o   Advocate for members and promote self-advocacy.

o   Deliver education to include health literacy, self-management skills, medication plans, and nutrition.

o   Monitor and evaluate effectiveness of the care management plan, assess adherence to care plan to ensure progress to goals and adjust and reevaluate as necessary.

o   Accurately document interactions that support management of the member.

o   Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to support continuity of care.

o   Educate the member and/or caregiver about post-transition care and needed follow-up, summarizing what happened during an episode of care.

o   Secure durable medical equipment and transportation services and communicate this to the member and/or caregiver and to key individuals at the receiving facility or home care agency.

o   Adhere to professional standards as outlined by protocols, rules and guidelines meeting quality and production goals.

o   Continue professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM).

EDUCATION AND EXPERIENCE

·       Nursing Diploma or Associates degree in nursing required.

·       Bachelor’s degree in nursing strongly preferred.

·       3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.

·       1 year of case management experience in a managed care setting strongly preferred.

·       Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.

CERTIFICATES, LICENSES, REGISTRATIONS

·       Current, active, and unrestricted Michigan Registered Nurse license required

·       Certification in Case Management (CCM) required or to be obtained within 18 months of hire

·       Certification in Chronic Care Professional (CCP) preferred

QUALIFICATIONS

·       To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

·       The requirements listed below are representative of the knowledge, skill, and/or ability required.

·       Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

OTHER SKILLS AND ABILITIES

·       Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member’s outcomes.

·       Empathetic, supportive and a good listener.

·       Proficient in motivational interviewing skills.

·       Demonstrated time management skills.

·       Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member.

·       Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.).

·       Must embrace teamwork but can also work independently.

Excellent interpersonal and communication skills both written and verbal.