Remote Remote Case Manager - Medication Adherence RN - Open to LPN & Very Experienced MA

Department: Value Based Care

Location: Remote - Occasional in-office meetings required. 
Hours: Full-Time; 40 Hours weekly

*Open to: RN - LPN - Very Experienced Medical Assistant*

Join Our Team at The South Bend Clinic!

At The South Bend Clinic, we strive for excellence—not just good enough. Every day, our dedicated team shows up inspired to exceed expectations, recognizing and celebrating the remarkable in everyone we encounter—inside and outside our workplace.

We’re more than a healthcare provider; we’re a partner in helping people live happier, healthier lives. We seek team members who share our relentless passion and pride for making a meaningful impact. We invest in your personal and professional growth, empowering you to fulfill your purpose and leave your mark.

Why Choose The South Bend Clinic?

We’re committed to supporting our team members in every aspect of their lives with holistic benefits designed to help you thrive:

• Financial Wellness:

  • Daily Pay: Access your earned wages when you need them.
  • Tuition Reimbursement: Up to $5,250 per year to support your education.
  • 401(k) Match: Plan for your future with our competitive matching program.
  • 3-Year Vesting: Achieve full ownership of your retirement contributions in just three years.

• Health & Well-Being:

  • Comprehensive medical and prescription coverage, including 100% coverage (after deductible) when using a Duly provider.
  • Pet Health Coverage: Because your furry friends matter too.

• Work-Life Balance:

  • Paid Volunteer Time: 40 hours of paid time off annually to give back to your community.
  • Parental Leave: 12 weeks of 100% paid parental leave, plus adoption and surrogacy financial benefits for non-physician team members.

• Inclusive Culture:

  • A workplace that prioritizes Diversity, Equity, and Inclusion (DEI) and is dedicated to making a positive social impact.

The RN Case Manager - Care Ally works in collaboration with physicians, patients and families to promote quality outcomes for patients with complex medical needs. The Case Manager is responsible for increasing efficient utilization of health care services; identifying chronic or catastrophic cases through the case management process and initiating intensive case management according to program guidelines. The Case Manager is responsible for managing patients in all health care settings to assure the appropriate level-of-care is provided, to prevent inpatient re-admissions and ensure that the patients' medical, environmental and psychosocial needs are met over the continuum of care. The Nurse Case Manager acts as an advocate through the coordination and communication with the health care team and family regarding care planning and implementation of recovery goals. In addition, the case manager will assess and coordinate resources available to patients and maximize the use of health care benefits.

• Analyze data collected from the predictive modeling tools to identify eligible patients for the Case Management Program.
• Enroll and manage a case load of patients with complex medical needs, completing case management attestations and initial assessments in accordance with health plan requirements.
• Develop individualized case management plans with prioritized goals and appropriate interventions in compliance with the risk stratification level requirements. In addition, complete all documentation, member communications, and case closures per policies and procedures.
• Proficient in knowledge of current Case Management Standards
• Coordinate Health Care Services with appropriate physicians and health care providers.
• Manage and provide a comprehensive summary and log of all active Case Management Cases as required by the UM/QA Committee and/or Health Plan.
• Act as a resource for Utilization Management Staff, physicians, office staff and Patients.
• Assist with the evaluation and amendment of Case Management Policy and Procedures
• Attend continuing education sessions and training relating to your job functions as required.
• Perform additional duties/tasks as assigned.

LICENSURE/CERTIFICATION:

• Must be an active Registered Nurse License in the State of Illinois in good standing.
• Certification in Case Management, preferred.
• Current CPR certification must be maintained (BLS).