Requisition #: 414925
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Non-Clinical Professional
Work Shift: Day Shift
Work Week: Full Time
Weekend Work Required: No
Date Posted: Sept. 20, 2021
Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.
Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.
The Case Manager anticipates and coordinates care / services / health education for targeted member populations with chronic disease conditions or high cost specialty care. She/he demonstrates knowledge of complex case management, prognosis and outcomes, and is responsible for ensuring that member goals are achieved within a specified time period based upon individual needs, reasonable expectations and well-documented outcomes.
- Bachelor’s Degree from an accredited school of nursing/related field; or RN currently enrolled in a bachelors program with a documented plan for completion. Equivalent experience may be substituted for a degree. Master’s Degree in Social Work is also accepted.
- Demonstrated clinical expertise.
- Knowledge of health care and managed care delivery systems.
- Standards of medical practice.
- Insurance benefit structures and related legal/ medical issues.
- Utilization management and quality improvement processes.
- Community resources.
- Clinical, satisfaction and financial outcomes.
- Ability to work in a dynamic, team-oriented environment and demonstrate positive relationship building.
- Effective verbal/ written communication.
- Ability to affect change.
- Ability to perform critical analysis, plan and organize effectively.
- Ability to promote member/family autonomy.
- Business acumen so that health benefits and member/provider satisfaction are maximized while solidifying the program’s viability through cost effective intervention.
- Additionally for Case Manager, Complex:
- Attitude and skills that facilitate patient engagement in their health care.
D. Required Licensure, Certification, Etc.:
- Current registered nurse licensure in the state of Maryland or LCSW-C.
- Certification in case management (CCM) preferred.
E. Work Experience:
- Minimum five (5) years clinical practice.
- Three (3) years case management. Managed care experience preferred.
Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.
Johns Hopkins Medicine.