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NURSE CASE MANAGER

NURSE CASE MANAGER

Team Wellness CorporationMinneapolis, MN, US
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Job Description

Job Description

Description :

TEAM Wellness Corporation is looking for a Nurse Case Manager to provide services to keep patients in the best physical condition by working both proactively and reactively. As a Nurse Case Manager, you will be responsible for overseeing and coordinating short-term and long-term medical care for patients and act as a member of the clinical team. At TEAM Wellness Corporation, we take a holistic approach to understanding client issues and have been providing quality employee assistance program services for members of the building trades for over 30 years.

The position is Monday-Friday, Full Time / In-Office. The Nurse Case Manager’s salary is $75,000 -$90,000 / year, commensurate with education and experience.

Education :

  • Bachelor of Science in Nursing (BSN) or Registered Nurse (RN) degree from an accredited college or university required.

Experience :

  • Experience in medical management, clinical nursing, case or disease management, health benefit plans, health insurance, home care services, or related field is required.
  • Telephone triage or call center background is a bonus.
  • Bilingual in Spanish is a bonus.
  • Essential Job Responsibilities

  • Provide telephonic, video, and on-site case management for patients with high-acuity and / or co-morbidities.
  • Facilitate access to healthcare providers, benefits information, and health resources.
  • Communicate clear, non-prescriptive messages about medical procedures and timelines to members.
  • Build relationships with members to develop collaborative action plans.
  • Coordinate communication among members, providers, and insurers, ensuring clarity on health questions and plan provisions.
  • Monitor the medical necessity and efficiency of care, collaborating with clinicians and medical directors as needed.
  • Participate in care coordination meetings to address delays and barriers.
  • Uphold TEAM values and continuous quality improvement in all tasks.
  • Stay informed about available benefits, community resources, and coverage information.
  • Maintain continuity of care through communication among patients, families, and providers.
  • Coordinate patient transfers to in-network facilities as appropriate.
  • Keep current with case management practices and relevant policies.
  • Ensure confidentiality of sensitive information.
  • Discuss cases not meeting medical necessity with the care team and clinical director.
  • Serve as a liaison for coordinating care transitions with other agencies.
  • Identify and refer complex cases to supervisors for review.
  • Record, monitor and report data such as clinical outcomes achieved, potentially avoidable and medically necessary variances, length of stay, reviews completed and outcomes, and discharge dispositions daily.
  • Collaborate with care team and attending provider to create actionable care and discharge plans.
  • Assess eligibility, benefits, and ongoing care needs for each case.
  • Function independently and as part of a team, working effectively with various departments, internal and external staff, facilities, clients, clients’ families, and providers to facilitate quality and efficient client care.
  • Provide on-site assessments based on assignment or request.
  • Provide assessments for clients referred on a mandated / formal basis by employers or unions. Solicit perspectives of the referring party as well as the client.
  • Explain benefits and resolve errors with providers and health plans.
  • Complete other assigned duties and projects.
  • The Nurse Case Manager position is an exempt position and includes benefits such as the following :

  • 401(k) and 401(k) Matching
  • Low Deductible Health and Dental Benefits
  • Life Insurance
  • Liability and malpractice insurance
  • License Reimbursement
  • Tuition reimbursement
  • Employee Assistance Program
  • Flexible Spending Account
  • Free Parking
  • Paid time off
  • License / Certification :

  • RN Minnesota License (Required)
  • Ability to Relocate :

  • Minneapolis, MN 55435 : Relocate before starting work (Required)
  • Requirements :

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