Certified Case Manager- Registered Nurse

Company Description

Accolade is a personalized health and benefits solution that dramatically improves the experience, outcomes and cost of healthcare for employers, health plans and their members. With a unique blend of compassionate advisors, clinical experts and intelligent technologies, we engage individuals and families in their health, establish trust, and influence their decisions at every stage of care. Accolade connects the widest array of personal health data and programs to present a single point of contact to the most effective health and benefits resources, while coordinating with providers at every step. Accolade consistently achieves 70 and higher Net Promoter Scores, 98% consumer satisfaction ratings, and up to 15% employer cost savings. Accolade has been recognized as one of the nation’s 25 most promising companies by Forbes, a fastest-growing private healthcare company by Inc. 5000, and is consistently rated a Top Workplace across the country. For more information, visit accolade.com.

Qualifications

As an Accolade RN Certified Case Manager Clinical Health Assistant, you will be a trusted go-to resource who helps our clients with any issues related to their health or health benefits.  You’ll have the opportunity to help clients get the right care at the right time… no problem is too big or too small. 

Accolade’s Case Management Team:

Accolade combines personal, dedicated support for consumers with extensive clinical needs to empower them to reach their optimal health and quality of life. Our RN Case Manager’s utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote/influence members decisions related to achieving and maintaining optimal health status. Utilizes clinical skills to coordinate, document and communicate all aspects of Accolades case management program. Requires an RN with unrestricted active license and CCM certification.

Accolade’s NCQA Case Management Accreditation:

 Accolade holds a Case Management Accreditation from the prestigious National Committee for Quality Assurance (NCQA).  NCQA, the National Committee for Quality Assurance, is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information through the web and media in order to help consumers, employers and others make more informed health care choices.

Requirements: Education, License & Certifications, skills and experience to be successful in this role.

  • Hold a current/active Certified Case Manager License (CCM)- Required  
  • Completed Bachelors Degree in Nursing (BSN) or equivalent
  • Minimum of 5 years as an active Registered Nurse with a current unrestricted license 
  • Case management and Discharge Planning experience- Required
  • Utilization Management & Managed Care experience- Preferred
  • Computer strength is a MUST – you’ll be listening, talking, typing – all at one time
  • Be an empathetic critical thinker – there are no scripts here – speak with your mind and heart, be able to think outside of the box on a large variety of topics from claims to colonoscopies!
  • Possess excellent communication skills, organization skills and have a high tolerance for ambiguity – change is how we grow!

 

A day in the life…

·         Describe what the day to day of the role looks like?

We do lot of great things over the phone, email, mobile instant messaging - on topics that include but are not limited to:

  • Be a trusted source > Building trust builds relationships > Building relationships enables you to ask deep rooted questions > Asking deep rooted questions enables you to influence care decisions
  • Conducting behavioral and clinical assessments to identify an individual’s behavioral and clinical needs in a holistic manner
  • Become knowledgeable on our clients’ employer-sponsored benefits so you’re able to answer questions around medical benefits, claims, care coordination and other complexities of the healthcare system. This will include Explain complicated medical and benefits terms in plain language
  • Educate individuals on appropriate care, and settings for their healthcare needs
  • Assist individuals to understand diagnostic tests, test alternatives, costs, risks, treatment options, preparing for hospital admissions, inpatient stays and discharge
  • Interfacing with clients’ health plans to facilitate coverage and care decisions, and direct individuals do facilities, agencies and specialists for care, work with client-appointed delegates and interface with providers to coordinate care
  • Get a holistic view of who our clients are, understand what’s important to them and provide options so they can make an informed decision about their true care needs
  • Educate and empower our clients so they’re able to confidently navigate the healthcare system – getting the right care at the right time is important 
  • Advocate for our clients who can’t advocate for themselves

·       What kind of projects would they work on outside of day to day?

o   Making Accolade the best place to work in the world is an “all in” job. Our Health Assistants area involved in Employee Resource Groups, Spirit Committees and other projects as they gain tenure in the organization.

Additional Information

What is important to us

Creating an enduring company that is hyper-focused on our culture and making a meaningful impact in the lives of our employees, members and customers. The secret to our success is:

We find joy and purpose in serving others

Making a difference in our members’ and customers’ lives is what we do.  Even when it’s hard, we do the right thing for the right reasons.

We are strong individually and together, we’re powerful

Trusting in our colleagues and embracing their different backgrounds and experiences enable us to solve tough problems in creative ways, having fun along the way.

We roll up our sleeves and get stuff done

Results motivate us. And we aren't afraid of the hard work or tough decisions needed to get us there.

We’re boldly and relentlessly reinventing healthcare

We're curious and act big - not afraid to knock down barriers or take calculated risks to change the world, one person at a time.

*All your information will be kept confidential according to EEO guidelines.


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