Back to Job Search

Case Manager, Health Coach

  • Location: Durham, 27707
  • Salary: $35 - $40 / hour
  • Job Type:Contract

Posted 13 days ago

Our Healthcare Insurance client is seeking a Case Manager, Health Coach to join their team for a contract role!

Our client has over 5,000 employees and is the number 1 health insurer in the state of North Carolina, serving more than 3.89 million customers. Health care is changing, and our client is leading the way by providing innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs. Our client is a not-for-profit with headquarters in Durham, NC.

Position: Case Manager, Health Coach
Term:  3 + Months
Location: Remote, North Carolina
Hours: One to two times per year, work 1 to 2 Saturdays for 4 hours.  One day per week work an evening which you choose which day. 

Required Skills 

  • RN with Associates degree or Bachelor of Science in Nursing (BSN).
  • Minimum of 3 years full-time direct clinical experience in an acute medical or acute surgical setting.
  • Proficiency with a Microsoft Windows operating system
  • Must have valid license to practice nursing within the US and have started application for NC nursing license.

Desired Skills 

  • Prior experience in a variety of health care settings is preferred
  • Experience with managing and coordinating care for patients who have multiple co-morbidities is preferred.
  • Utilization and Quality Management/Outcomes experience preferred.
  • Previous work experience with a managed care organization or provider is preferred.
  • Prior experience in case management, home health, discharge planning, or concurrent review is preferred.
  • For Senior Segment: Experience in responding to the diverse needs of the Medicare population, which includes both over 65 and under 65 aged adults.
  • For Commercial Care Management: Multi-State Licensure preferred
  • Certified Case Manager (CCM) or Certified Health Coach (CHC) certification is preferred at time of hire.
  • For case management roles: those without Certified Case Manager (CCM) certification at time of hire are required to sit for the certification exam within 2 years of employment. Attainment of certification is required within 3 years of employment

Description/Comment:
The Case Manager / Health Coach coordinates the care and services of selected member populations across the continuum of care, promotes effective utilization and monitoring of health care resources, and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resource outcomes.

  • Serve as a team member on a multidisciplinary team that monitors utilization patterns; identifies and facilitates appropriate health care service delivery for selected members, providers, procedures, and/or diagnoses; and improves the quality and cost efficiency of care and service
  • The application of the Case Manager or Health Coachs knowledge and clinical skills will vary across the Health Care division, dependent on focus areas identified by the business area supported.
  • Outreach to members identified as high risk, high cost, or high utilization cases.
  • Encourage pro-active intervention to limit expense and encourage positive outcomes.
  • Perform a comprehensive assessment of the members health status, educational, and level of support needs.
  • Develop a member-centric care plan which includes a self-management plan tailored to members needs, and identification of barriers to meeting goals or plan of care.
  • Utilize community resources and funding sources in the development of the plan of care.
  • Perform ongoing monitoring and management of member including: scheduled follow-up with member, discussion of plan with member, appropriate services/education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plan/goals as needed, with contact frequency appropriate to member acuity.
  • Evaluate and facilitate care provided to members through the continuum of care (physician office, hospital, rehabilitation unit, skilled nursing facility, home care).
  • Review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options, where eligible.
  • May evaluate medical necessity and appropriateness of services as defined by department.
  • Document all aspects of the plan from the initial assessment, development of the plan, implementation, monitoring, and evaluating outcome.
  • Complete all correspondence related to case management, including all calls and faxes with phone and fax numbers noted. Obtain consents as indicated.

****To be eligible to contract at this client you must be able to pass a drug test and criminal background check.
 

Candidates will be responsible for following the client's COVID-19 protocols. Please refer to your MATRIX representative for specifics.

About Us

At MATRIX, we expertly match talented professionals with job opportunities to elevate careers. Since 1983, we have placed thousands of professionals at innovative clients across every industry ranging from small startups to Fortune 50 companies. It’s why we’re a top 15 U.S. IT staffing firm and why our consultants rate us well above the industry average. People come to us for a job, and stay with us because of our top-notch consultant care.

For hourly W2 contract roles, MATRIX offers a highly competitive benefit package including Medical, Dental, Vision, Life, Disability, HSA, and 401(k) with pre and post-tax options. Please see https://www.matrixres.com/consultants-overview/benefits-and-payroll for more information. For direct hire placement with our clients, benefits will be offered in accordance with that particular client’s offerings. This may include PTO, Medical, Dental, Vision, 401K and other pre and post-tax options.

MATRIX is an Equal Opportunity Employer, including disability/vets. All applicants must be currently authorized to work on a full-time basis in the country for which they are applying, and no sponsorship is currently available. Employment is subject to the successful completion of a pre-employment screening. Accommodation will be provided in all parts of the hiring process as required under Motion Recruitment Employment Accommodation policy. Applicants need to make their needs known in advance.