Care Manager I
4 weeks ago
03 months
60-day contract position. Compact License
Licenses/Certifications: Current state's RN license.
Compact RN License
Remote
8a-5p
Position Purpose:
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care
* Develop, assess and adjust, as necessary, the care plan and promote desired outcome
* Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
* Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
* Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
* Provide patient and provider education
* Facilitate member access to community based services
* Monitor referrals made to community based organizations, medical care and other services to support the members' overall care management plan
* Actively participate in integrated team care management rounds
* Identify related risk management quality concerns and report these scenarios to the appropriate resources
* Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
Qualifications - External
Education/Experience:
Graduate from an Accredited School of Nursing.
Associate's degree.
Knowledge of healthcare and managed care preferred.
Knowledge of healthcare and managed care preferred.
Prior experience working in a remote role preferred.
Prior case management experience preferred.
Bilingual in Spanish and English is preferred.
Licenses/Certifications: Current state's RN license.
*Pediatrics - birth to 21
*Work-from-home case management role
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