Bilingual Field RN Case Manager

Bring your heart to Signify Health Every one of us at Signify Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at Signify Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

Requirement to reside in Greenville, South Carolina, or within commuting distance of Greenville.

50-75% of time will be spent in provider offices in and around Greenville.

Working schedule is Monday-Friday; will work between 8am – 6pm EST.

Fundamental Components & Physical Requirements:
* Collaborates with the ACO provider partners in their office(s) to determine which beneficiaries would benefit most from case management services. Communicates with the provider partner(s) as to course of care and treatments as appropriate.
* Acts in the role of embedded case manager within the provider partner(s) offices to meet with the beneficiaries in conjunction with their provider appointments.
* Implements and coordinates all case management activities relating to catastrophic cases and chronically ill beneficiaries across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. Interacts with members/clients telephonically or in person in the provider partner(s) offices.
* May be required to interact with beneficiaries via telephone, if unable to meet with the beneficiary during physician visits and to provide ongoing case management services.
* Assesses and analyzes injured, acute, or chronically ill beneficiaries medical and/or vocational status; develops a plan of care to facilitate the beneficiaries appropriate condition management to optimize wellness and medical outcomes, aid in optimal functioning, and determination of eligibility for benefits as appropriate.
* Communicates with beneficiary and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.
* Prepares all required documentation of case work activities as appropriate.
* Interacts, consults, and make appropriate referrals to/with internal multidisciplinary team as indicated to help beneficiary maximize best health outcomes.
* Provides educational and prevention information for best medical outcomes.
* Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by Medicare and referral sources.
* Conducts an evaluation of beneficiaries needs and facilitates integrative functions using clinical tools and information/data.
* Utilizes case management processes in compliance with regulatory and company policies and procedures. Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function.                                                  

*  Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a beneficiary’s overall wellness through integration. Monitors beneficiary progress toward desired outcomes through assessment and evaluation.
* Acts as a liaison with beneficiary, family, provider(s), and healthcare personnel as appropriate.
* Prepares all required documentation of case work activities as appropriate.

Required Qualifications
Requirement to reside in Greenville, South Carolina, or within commuting distance of Greenville.
A Registered Nurse that must hold an unrestricted license in their state of South Carolina residence.

Bilingual Spanish and English required.
3+ years clinical experience required with at least 1 year of experience in one of the following areas: critical care, ICU, CCU, Emergency
2+ years case management experience required
Must be willing to travel up to 75% throughout various areas of Greenville.
Reliable transportation required
Mileage is reimbursed per our company expense reimbursement policy

Depending on requirements of provider offices, certain vaccines (i.e., COVID, Flu) may be a requirement of the role, as well as additional health screenings (i.e., drug screen, vaccine titers).

Preferred Qualifications
Managed Care experience preferred
Medicare experience preferred

Experience working in health care provider office setting preferred.
Advanced Care Planning Experience preferred
CCM Certification
Excellent analytic and problem-solving skills
Ability to work independently (this position will be field work and work from home)
Effective computer skills including navigating multiple systems and keyboarding

Education
Associates degree RN required

BSN preferred

About Us:
Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.
Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.
To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com.

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.
We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.

 

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Last updated on Nov 14, 2023