Case Manager

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company. Point C is seeking a compassionate and detail-oriented Case Management Nurse to support patients on their journey to better health and well-being. In this role, you’ll serve as a critical liaison between patients, providers, care teams, and community resources—ensuring continuity of care and adherence to treatment plans. Primary Responsibilities: Create and promote adherence to treatment plans, as developed by patients’ healthcare providers Create and maintain accurate, detailed clinical patient reports for clients and carriers Monitor and document adherence to treatment plans, evaluate effectiveness, monitor patient progress in a timely manner Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals Increase patients’ ability for self-management and shared decision making Increase comprehension through culturally and linguistically appropriate education Assist with medication reconciliation Connect patients to relevant community resources, with the goal of enhancing patient health and wellbeing. Serve as the contact point, advocate, and informational resource for patients, care team, family/caregiver(s), stop-loss carrier, and community resources Assess a patient’s unmet health and social needs Acknowledges patient’s right on confidentiality issues, always maintains patient confidentiality and follows HIPAA guidelines and regulations Qualifications: Current standing as a registered nurse (RN) or licensed practical nurse (LPN) required 5 years of experience in a clinical or community resource setting/care coordination required 2 years of case management experience required Highly organized with ability to keep accurate notes and records Evidence of essential leadership, communication, education and counseling skills Proficient computing skills and the ability to learn new systems Exemplary telecommunication skills Maintains high level of professionalism and confidentiality Individual compensation will be commensurate with the candidate's experience and qualifications. Certain roles may be eligible for additional compensation, including bonuses, and merit increases. Additionally, certain roles have the opportunity to receive sales commissions that are based on the terms of the sales commission plan applicable to the role. Pay Transparency $70,000 — $80,000 USD Benefits: Comprehensive medical, dental, vision, and life insurance coverage 401(k) retirement plan with employer match Health Savings Account (HSA) & Flexible Spending Accounts (FSAs) Paid time off (PTO) and disability leave Employee Assistance Program (EAP) Equal Employment Opportunity : At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and…