Case Manager Nurse - RN - Part-Time

2w2 weeks ago

Personify Health

US · Part-time · $72,000 – $76,000

About this role

Personify Health created the first and only personalized health platform, bringing health plan administration, wellbeing solutions, and care navigation together. We are seeking a part-time Case Manager Nurse, RN, to provide telephonic case management between providers, patients, and caregivers, ensuring cost-effective, high-quality healthcare for plan participants.

In this role, you will contact patients to complete thorough assessments covering physical, psychosocial, emotional, and financial needs. You will use claims data to develop a clinical picture and treatment plan with short- and long-term goals, then monitor interventions and report measurable outcomes.

You will collaborate with patients, families, providers, and multidisciplinary teams throughout the continuum of care, advocating for quality care and cost reduction. As a mentor, you will guide LVNs on complicated clinical cases and maintain relationships with healthcare providers to ensure coordinated care.

This part-time role offers the chance to make a significant impact on patients' health while maintaining reduced hours. You will negotiate cost management strategies and document case outcomes, contributing to the company's data-driven mission of empowering healthier lives.

Requirements

Graduation from an accredited Registered Nursing (RN) program.
Possession of a current California RN license; a multi-state license will also be required.
Minimum of five (5) years medical/surgical or acute care experience, including two years’ experience in case management, or an equivalent combination of education and experience.
Prior case management, emergency room, or critical care background preferred.

Responsibilities

Contact patients and complete thorough assessments including physical, psychosocial, emotional, spiritual, environmental, and financial needs.
Use claims processing tools to review paid claim data and develop a clinical picture of member health.
Develop treatment plans in collaboration with patients, caregivers, and multidisciplinary healthcare providers.
Monitor interventions and evaluate treatment plan effectiveness, reporting measurable outcomes.
Advocate for patients by facilitating quality care and assisting in reducing overall costs.
Negotiate and implement cost management strategies to affect quality outcomes.
Maintain complete and detailed documentation of case managed patients, ensuring confidentiality per HIPAA.
Serve as a mentor to LVNs, providing guidance on complicated clinical cases.

Benefits

Flexible part-time schedule ideal for reduced hours while making an impact.
Opportunity to serve as a mentor to LVNs and guide clinical cases.
Work with the first and only personalized health platform integrating health plan administration, wellbeing solutions, and care navigation.
Contribute to improving health outcomes through data-driven case management.