Case Manager, D-SNP, Health Plan

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. 

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

40

Salary Range: $31.00 - $49.50

Union Position:

No

Department Details

Remote position in the Bismarck area.
An opportunity to make a direct impact on member lives by coordinating care, advocating for their needs, and assisting in managing complex cases.
Hours are Monday through Friday, 8 to 5 pm, no weekends or holidays

Summary

The Case Manager, D-SNP is responsible for providing case management services for medically and/or socially complex members. The target member population includes individuals with significantly complex medical conditions, and/or social-economic, or mental health needs. The goal of the program is to assist these members in achieving optimal health and/or independence in managing their care. To achieve this goal the Case Manager, D-SNP will demonstrate and apply knowledge of the philosophy/principles of comprehensive case management, patient-centered, culturally sensitive care coordination, and management of complex members.

Job Description

The Case Manager is responsible for providing case management services to D-SNP members in alignment with the approved Model of Care. The Case Manager, D-SNP is responsible for meeting all of the CMS required care coordination activities, including conducting Health Risk Assessments, developing Individualized Care Plans, convening Interdisciplinary Care Team meetings, managing Transitions of Care, and conducting at least one Face-to-Face visit per year for all assigned members to occur at the member's residence or at the location of the member's choosing

The Case Manager, D-SNP is responsible for the management of assigned D-SNP members to ensure quality of care is maintained as the patient accesses care and services across the continuum of care. Case Manager, D-SNP will conduct a timely Health Risk Assessment which includes physical, psychological, emotional and social determinants of health assessments, for the purpose of providing appropriate, timely interventions to ensure provision of optimal care. An assessment is completed of the member's formal and informal support systems, including caregiver resources and involvement as well as available benefits and/or community resources, including Medicaid and Medicaid Waiver services. Coordination and collaboration with State of ND Medicaid and Medicaid Waiver program case managers and providers, community-based organization case managers, and services to address barriers and needs

Based upon the assessment, the Case Manager, D-SNP will identify member strengths, preferences, goals, needs, interventions and providers. An individualized care plan will be developed for each member along with the member and/or family and through collaboration with the Interdisciplinary Care Team (ICT) which includes prioritized goals that consider the member/caregiver goals, preferences, and desired level of involvement in the case management plan to meet the member's needs. The case manager will evaluate member's progress toward goal achievement, including identification and evaluation of barriers to meeting or complying with the case management individualized care plan, and systematically reassess for changes in goals and/or health status. Interventions included in the care plan will demonstrate knowledge of and sensitivity toward cultural diversity and religious, developmental, health literacy, and educational backgrounds of the population served.

The Case Manager, D-SNP will coordinate and actively participate in care conferences to enhance communication and promote continuity of care with the Interdisciplinary Team (ICT). The Case Manager, D-SNP will work collaboratively with the interdisciplinary care team (ICT) to develop and update a person-centered care plan.

Qualifications

Bachelor's degree in nursing required. Graduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE). Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA) is strongly preferred.

Minimum of three years clinical experience is required. Additional experience in case management, care coordination, managed care, transitions of care, behavioral health and/or discharge planning preferred. Experience working with the Medicare and Medicaid populations is preferred.

Currently licensed with the applicable state nursing board and/or possess multistate licensure privileges as required by position. Current Commission for Case Manager Certification (CCMC) is preferred or is to be obtained within two years of employment. Valid Drivers License required.

Sanford is an EEO/AA Employer M/F/Disability/Vet. 

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.