Case Management - Nurse, Senior (DSNP)

The Case Management – Nurse, Senior will manage a caseload of DSNP members, review Health Risk Assessments, and complete Individualized Care Plans to reduce readmissions to the hospital. This role requires creative and critical thinking, building high-performing teams, and fostering continuous learning.

Requirements

• Research and design treatment/care plans to promote quality of care
• Initiate timely individualized care plans based on health risk assessment
• Determine appropriateness of referral for CM services, mental health, and social services
• Provide referrals to Quality Management, Disease Management, and Appeals and Grievance department
• Conduct member care review with medical groups or individual providers for continuity of care
• Manage member treatment to meet recommended length of stay
• Assess members' health behaviors, cultural influences, and clients' belief/value system
• Research opportunities for improvement in assessment methodology and actively promote continuous improvement