Case Manager

2 weeks ago

Durham, United States Experis Full time

Hi,

This is Gayatri, a senior recruiter at Experis IT Manpower Group. Experis IT ManpowerGroup has partnered with a leading healthcare insurance company for a case manager role to assist their team. This is a Remote role.

Industry: Healthcare Insurance Co
Title:  Case Manager
Location: Remote (EST or CST)
Duration: 6+ months
Pay range:  $41/hr on W2

Job Description
We seek a highly motivated and experienced professional to join our multidisciplinary team. The ideal candidate will excel in coordinating care, resources, and services for our members to achieve optimal clinical and resource outcomes.
•    Serve as a team member on a multidisciplinary team, coordinating care, resources, and/or services for members to achieve optimal clinical and resource outcomes. 
•    Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with family members, internal partners and external services and providers on plans for treatment, appropriate intervention, and/or discharge planning.
•    Develop a member-centric plan tailored to members’ needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care 
•    Utilize community resources and funding sources as needed in the development of the plan of care.
•    Perform ongoing monitoring and management of members, which may include scheduled follow-up with member, discussion of plan with member, appropriate services and education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plans and goals as needed, and 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, etc).
•    Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes 
• Effectively document all aspects of the plan, from the initial assessment, development of the plan, implementation, monitoring, and evaluation of the outcome. 
• May outreach directly to members identified as high-risk, high-cost, or high-utilization cases.
• May review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exceptions or flex benefit options, where eligible.
• May evaluate the medical necessity and appropriateness of services as defined by the department.
• As needed, develop relevant policies, procedures, education, or training for use both internally and externally.

Hiring Requirements
• An RN, RD, or LCSW with 3 years of clinical and/or case management experience is required. For some roles, a Master's in Social Work with 5 years of related experience may be considered.
• For behavioral health-specific roles, other applicable licensure may be considered with a minimum of 3 years of clinical experience.
• Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform the described job duties.
• For some roles, additional specialty certification (i.e., CCM, CDCES) may be required.  If so, incumbents must obtain relevant certification within 2 years of employment.

 

If this is a role that interests you and you’d like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you

 

About ManpowerGroup, Parent Company of:  Manpower, Experis, Talent Solutions, and Jefferson Wells

ManpowerGroup® (NYSE: MAN), the leading global workforce solutions company, helps organizations transform in a fast-changing world of work by sourcing, assessing, developing, and managing the talent that enables them to win. We develop innovative solutions for hundreds of thousands of organizations every year, providing them with skilled talent while finding meaningful, sustainable employment for millions of people across a wide range of industries and skills. Our expert family of brands – Manpower, Experis, Talent Solutions, and Jefferson Wells – creates substantial value for candidates and clients across more than 75 countries and territories and has done so for over 70 years. We are recognized consistently for our diversity - as a best place to work for Women, Inclusion, Equality and Disability and in 2022 ManpowerGroup was named one of the World's Most Ethical Companies for the 13th year - all confirming our position as the brand of choice for in-demand talent.

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