Sr. Case Manager RN

Summary/Position Objectives:
Under the direction of the Case Management Supervisor, provides case management to assigned members identified as High Risk that require medical intervention and monitoring.

Responsibilities:
Essential Functions:
Serve as interdisciplinary team member in management of identified members, performing medical/ social - status assessments and in collaboration with physicians, determining appropriate medical services.
Maintain necessary documentation in business application system, according to health plan policy and procedures.
Assist in establishing network of providers to meet the special needs of at risk members.
Represent health plan at various meetings with community agencies that provide services to members.
Assist in discharge planning with Utilization Review.
Act as liaison between PCP and member with problems that are identified that potentially could interrupt care.
Provide education and in-service to providers and health plan staff on identified diseases and social circumstances which result in high utilization of services.
Prepare reports for AHCCCS and health plan as needed.
Serve as resource to peers.
Assure data integrity in business application system for member’s managed cases.
Attend routine staff meetings and in-services.
Works in a manner that is not disruptive to peers, supervisors and subordinates.
Performs other duties, assignments and responsibilities as assigned or required.
Secondary Functions:
Works in a manner that is not disruptive to peers, supervisors and/or subordinates.
Must maintain regular and acceptable attendance at such level as is determined in the employer’s sole discretion.
Must be available and willing to work such days and hours as the employer determines are necessary or desirable to meet its business needs.
Must be available and willing to travel to such locations and with such frequency as the employer determines is necessary or desirable to meet its business needs. (If travel required.)
REQUIREMENTS
Knowledge and Skills:
Complex choice of action - requires considerable logic, understanding to analyze problem and determine course of action
Fractions, ratios, decimals, percentages, graphs
Communicates, writes, advises and counsels on extremely complex matters.
Requires tact, insight, leadership
Personal computers

Education and Work Experience:
RN required, BSN preferred.
Three years experience in Public Health, Home Health, Senior Living/Nursing Home, or other Community Health providing services to clients within the home setting. Must have experience helping members using community agencies. Medicare experience preferred.


Schaller Anderson team members are provided with countless opportunities to make a real difference and the following compensation/benefits:

* Competitive compensation DOE
* Medical, Dental and Vision insurance
* Employee Assistance Program
* Flexible spending accounts
* On-site fitness center (Phoenix headquarters only)
* Life insurance and accidental death and dismemberment insurance
* Short-term and long-term disability
* Paid holidays, paid time off/paid time off reserve
* 401(k)
* Tuition reimbursement
Visit www.schalleranderson.com for more information or submit a resume to [Click here for email]. EOE