RN Case Manager

Company: Quantum Health
Location: Columbus
Posted on: January 16, 2021

Job Description:

**All clinical positions are located onsite in our offices in Columbus**As a Case Manager you are a key member of a cross-functional team driven by their mutual devotion to serve others. Your members view you as their personal care guide as you advocate for them during some of the most challenging times of their life-facing catastrophic illness, injury or acute and chronic medical conditions. Your clinical expertise and integrated health approach provides each unique patient with education and guidance as they navigate the complexities of health care. And because you sincerely care for the experience of members, you proactively offer your expertise to other members of the team. How can you make a lasting impact?

• Identify members for specific case management and/or chronic condition management activities using established screening criteria
• Apply nursing processes to actively manage members and achieve integrated health services through coordinated service efforts
• Provide education and guidance to members and providers to successfully navigate healthcare complexities
• Maintain high quality of care by:
  • Adhering to therapeutic standards
  • Measuring health outcomes against member care goals and standards
  • Making/recommending necessary care adjustments
  • Following hospital and nursing division's philosophies and standards of care set by state board of nursing, state nurse practice act and other governing agency regulations
  • Document all activities specific to members, caregivers, providers, facilities and clients in appropriate databases
  • Maintain collaborative relationships amongst health care teams through effective communication, responsiveness, building rapport and collaborative problem solving
  • Assist members and clients with wellness activities, enhanced benefits and behavioral incentives
  • Maintain working knowledge of all policies and procedures related to Clinical Operations, employer health benefit plans and where to access benefit information What do you need to succeed?
    • Active Registered Nurse license in Ohio
    • 5 years of direct patient care clinical experience preferred; minimum 2 years required
    • Bachelor of Science in Nursing (BSN) preferred
    • Experience and/or Certification in Case Management (CCM) preferred
    • Confident clinical judgement with excellent critical thinking
    • Excellent time management as an independent worker with minimum supervision
    • Computer proficiency including using MS Office, navigating multiple programs simultaneously and accurate typing at speed Full-time position requires successful completion, via testing, of 6 - 7 weeks of training Monday - Friday from 9:00 AM - 6:00 PM. Upon completion, available shifts will be within 9:00 AM - 8:00 PM, Monday - Friday as business needs dictate. What's in it for you?
      • Paid-time-off, paid holidays and weekends free
      • Comprehensive Medical/Dental/Vision insurance including domestic partner benefits
      • 401k with 4% match
      • On-site fitness facility, ping pong table, serenity room massage chairs
      • Education reimbursement after a year of service
      • Supportive Engagement Teams i.e. Women, LGBTQIA, etc. Quantum Health nurtures an award-winning, highly-engaging culture that supports each member as an individual, provides continuous development opportunities and career growth. Our work is serious but our laid back, fun environment fuels each of our 1,200+ employees to make lasting impact on our members and families' lives. We are the healthcare warriors for nearly 200 businesses and their employees providing comprehensive guidance as they navigate their self-funded healthcare plans. Our work cuts costs, maximizes the benefits portfolio and achieves the best employee experience for each medical situation. Quantum Health is an Equal Opportunity Employer

Keywords: Quantum Health, Columbus , RN Case Manager, Executive , Columbus, Ohio