Rn Outpatient Case Manager

We’ve made a lot of progress since opening the doors in 1942, but one thing has never changed – our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

The Manager manages complex/catastrophic patients assigned to Ochsner Network Primary Care Physicians. Utilizes the Case Management process to assess the health care needs of the enrollee, develop a comprehensive treatment plan complete with specific goals and objectives, implement a treatment plan in collaboration with the PCP team and the other providers involved in the patient’s care, negotiate and coordinate services for the patient, monitor and evaluate the effectiveness of the plan in achieving the goals and objectives, and change and modify the plan as needs and situations change. This job is embedded within the Primary Care Practice and participates as a key team member in the Patient Centered Medical Home. Assumes responsibility for coordinating care among multiple healthcare providers, the patient’s caregiver(s), community services, payors, and others involved in the care of the patient to ensure services are provided seamlessly throughout the continuum of care. Arranges and coordinates resources necessary to manage the patient’s disease processes in the home environment and at alternate levels of care (SNF/LTAC/Rehab/Custodial Nursing Home) throughout the care continuum and adheres to the CMSA Standards of Practice for Case Management.

Education

Required – Associates degree

Preferred – Bachelor’s degree in Nursing, additional degrees, business training experience and/or certifications may be combined to meet minimum qualifications.

Work Experience
Required – 6 years experience in managed care, utilization or quality management, regulatory compliance, medical management or other related MCO departments/functions with certification as a CCM. Experience with data capture in a Care Management software system, such as CaseTrakker, CCMS, Amisys, and Facets. Experience with Microsoft Office software tools.

Certifications

Required – Registered Nurse in the state of Louisiana

Certification as a Case Manager (CCM) required within 2 years of hire

Other

Required – Three years experience in managed care, utilization or quality management, regulatory compliance, medical management or other related MCO departments/functions with BSN

Knowledge Skills and Abilities (KSAs)

• Strong written and verbal communication skills
• Good organizational skills
• Excellent knowledge of managed care, CMS, Medicaid and other regulatory standards/requirements. Knowledge and experience in using, community resources and other resources to facilitate the patient’s care throughout the care continuum.
• Demonstrates Good Judgement
• Must have computer skills and dexterity required for data entry and retrieval of patient information. Must be proficient with Windows-style applications and keyboard.
• Strong time management skills and self directed
• Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals.

Other related duties as required. The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

Complies with the Ochsner Health System Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns.

Ochsner is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the state of Colorado are not eligible for remote work position.

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