Registered Nurse (RN) Community Based Case Manager
Monday - Friday, 8am-5pm
The Community Based/Case Management Team is part of the larger Clinical Care Services team at Optima Health. The selected RN for this position will join our team which supports our members in the state of Ohio as part of our Ohio Health plan services. Our Registered Nurses become certified case managers who coordinate the care and services of our members, promote effective utilization and monitor health care resources. The Community Based Ohio Healthy plan case manager functions in a telephonic/office-based capacity and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resources outcomes. Members of our team are responsible for the utilization management and review, coordination of benefits and assisting with the coordination of transition plans. Minimum BSN degree required and at least 3 years of RN experience, preferably in case management.
Optima Health offers a full suite of commercial health insurance products including employee-owned and employer-sponsored plans, as well as Individual and Family health plans, employee assistance plans and plans serving Medicare and Medicaid enrollees. We offer programs to support members with chronic illnesses, customized wellness programs, and integrated clinical and behavioral health services.
As a nationally recognized provider of health plan coverage and innovative wellness programs, we live our mission “to improve health everyday.” This same commitment and dedication directs our philosophy as an employer. When you join Optima Health, you will experience our deep passion for heal and service excellence while benefiting from a culture of opportunity, learning, career growth, and support -every day. Optima Health is a service of Sentara Healthcare, so joining Optima is joining the Sentara Healthcare family.
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, CLICK HERE!
Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!
Responsible and accountable for the provision and facilitation of comprehensive care coordination services and quality outcomes for patients across the continuum. Promotes effective utilization and monitoring of health services, collaborates and communicates with the healthcare team and patient/caregiver to manage care and transitions. Develops and/or implements a comprehensive care plan based on assessment and evaluation of patient/caregiver needs. Functions in one of the following practice settings: Acute Care, Service Lines, Ambulatory/Community-based, Home Health, and Long Term Care.
RN-Bachelor's Level Degree
Required: Nursing - 3 years
Required: Registered Nurse
Preferred: Basic Life Support
Required: Communication, Critical Thinking, Service Orientation
BLS (if in a clinical setting). For Integrated Care Management departments, specialty certification required within one year of eligibility (ACM, CCM, CCCTM or RN-BC). For other service lines, certification based on specialty area required within one year of eligibility. 3 years Case Management experience preferred. For those in Behavioral Health - Certification in de-escalation training within 15 days of hire and annually.
Keyword: RN, Registered Nurse, case management, care manager, community-based, telephonic, managed care
Equal Opportunity Employer