Registered Nurse RN Arizona Long Term Care Case Manager Remote

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You have a place in the health care industry. If you’re looking to leverage your abilities to make a real difference – and real change in the health care industry – you belong at Banner Health. Apply today.

Banner Health has been recognized by Becker’s Healthcare as one of the 150 top places to work in health care. In addition, we recently made Newsweek’s list of America’s Greatest Workplaces 2023 for Diversity. These recognitions reflect Banner Health's investment in team members' professional development, wellness benefits, and continued education. It highlights our commitment to advocating for diversity in the workplace, promoting work-life balance, and boosting employee engagement.

As an Arizona Long Term Care Case Manager, you will utilize your case management background knowledge to advocate and support members with their health management. You will collaborate with interdisciplinary teams to improve outcomes for members in the community. You will also assist the non-clinical Case Management team members with member care needs.

You will work in an entirely remote setting. Shifts are Monday-Friday 8:00 a.m. - 5:00 p.m. This role requires Arizona residency. If this sounds like the role for you apply today!

POSITION SUMMARY
This position will be responsible to case manage complex chronic and rising risk members in the populations as assigned. He/she will be the main point of contact for members and providers across care settings. The aim is to better manage patients in the ambulatory and home and community-based setting by following patients deemed as or of becoming heavy users of care due to multiple chronic illnesses, high ED utilization, or a recent discharge from a skilled nursing facility, etc. The RN engages the appropriate resources within the multidisciplinary team to achieve optimal results for the patient, family, and care givers. This position provides comprehensive care coordination for patients as assigned. This position assesses the patient’s plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care, facilitating options and services to meet the patients’ health care needs cost-effectively
CORE FUNCTIONS
1. Manages individual patients or members across the health care continuum (longitudinal support) to achieve the optimal clinical, financial, operational, and satisfaction outcomes. Provides disease management or referral to disease management support in ancillary areas (i.e. pharmacy, social work, palliative, etc...)
2. Acts in a leadership function to collaboratively develop and manage the interdisciplinary patient or member care plan. Effectively communicates the plan across the continuum of care. Ensures care plan consistency across providers.
3. Acts in a leadership function with process improvement activities for populations of patients or members. Provides patient or member monitoring, education, and supports care plan adherence.
4. Promotes a more active and informed role in patient or member self-care; navigates patients or members identified as high-risk across the continuum, longitudinally to ensure that the member is receiving the most appropriate, cost-effective services in the appropriate setting.
5. Establishes and promotes a collaborative relationship with physicians, payers, and other members of the health care team. Collects and communicates pertinent, timely information to payers and others to fulfill utilization and regulatory requirements.
6. Educates internal members of the health care team on care management and managed care concepts. Facilitates integration of concepts into daily practice.
7. This position has the freedom to determine how to best accomplish functions within established procedures. Confers with supervisor on any unusual situations. Positions are entity based with no budgetary responsibility. Internal customers: All levels of nursing management and staff, medical staff, and all other members of the interdisciplinary health care team. External customers: Physicians and their office staff, payers, community agencies, provider networks, and regulatory agencies.
MINIMUM QUALIFICATIONS

Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care.
Requires current Registered Nurse (R.N.) license in state worked. For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.
Three years of experience directly related to Care Management in a Health Plan, Health Management, or Quality.
PREFERRED QUALIFICATIONS

Certification with nationally recognized healthcare organization, such as CCM, preferred. Ability to speak Spanish preferred.
Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

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