Case Manager, Complex
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Job Location:
Hanover, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
What awaits you:
- Work-life balance -This is a remote role.
- Medical Dental and Vision Insurance.
- 403B Savings Plan w/employer contribution.
- Generous Paid Time Off
- Employee and Dependent Tuition assistance benefits.
- Health and wellness programs and MORE!
Who you are:
The Case Manager anticipates and coordinates care / services / health education for targeted patient populations with chronic disease conditions or high cost specialty care. She/he demonstrates knowledge of case and disease management prognosis and outcomes and is responsible for ensuring that patient goals are achieved within a specified time period based upon individual needs reasonable expectations and well-documented outcomes.
- Current registered nurse licensure in the state of Maryland or LCSW-C.
What youll do:
- Identifies and acts upon impending changes in patient condition.
- Identifies and analyzes staff/patient/system issues that impact the plan of care.
- Initiates corrective action.
- Reviews/interprets patient population specific financial reports.
- Maintains budgeted caseload
- Makes decisions regarding work processes based on established guidelines.
- Understands and uses principles of negotiation.
- Effectively uses resources within control.
- May assign work to support staff
What youll bring:
- Demonstrated clinical expertise in acute care nursing with clinical expertise in a specialty area preferred.
- Knowledge of health care and managed care delivery systems.
- Standards of medical practice.
- Insurance benefit structures and related legal/ medical issues.
- Utilization management and quality improvement processes.
- Community resources.
- Ability to work in a dynamic team-oriented environment and demonstrate positive relationship building.
- Effective verbal/ written communication.
- Ability to affect change.
- Ability to perform critical analysis plan and organize effectively.
- Ability to promote patient/family autonomy.
- Business acumen so that health benefits and patient/provider satisfaction are maximized while solidifying the programs viability through cost effective intervention.
Education: Bachelors degree in nursing or related years of experience or MSW in social work preferred.
Work Experience:
- Minimum five (5) years clinical practice.
- Minimum three (3) years clinical practice in a specific specialty.
- Additional case management/ disease management or managed care experience preferred.
Licensure:
- Current registered nurse licensure in the state of Maryland or LCSW-C.
- Certification in case management (CCM) preferred.
Who we are:
Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500000 active members with lines of business in Medicaid Medicare commercial military health health solutions and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare at Johns Hopkins Health Plans we are setting the pace for change within the healthcare industry. We develop innovative analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.
Salary Range: Minimum 39.94/hour - Maximum 61.91/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount salary discussions will occur during candidate screening calls before any subsequent compensation discussion is held between the candidate and any hiring authority.
We are committed to creating a welcoming and inclusive environment where we embrace and celebrate our differences where all employees feel valued contribute to our mission of serving the community and engage in equitable healthcare delivery and workforce practices.
Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.
Johns Hopkins Health System and its affiliates are drug-free workplace employers.
Required Experience:
Manager
Key Skills
- Project Portfolio Management
- Motivational Interviewing
- HIPAA
- Computer Skills
- Intake Experience
- Lean Six Sigma
- Conflict Management
- Case Management
- Team Management
- Program Development
- Social Work
- Addiction Counseling
About Company
Johns Hopkins Medicine is a leading health system and academic institution in the U.S. Find information about doctors, locations, appointments, billing, research, education and more.
