Care Manager I

3 weeks ago


Lansing, United States Spectraforce Technologies Full time

Job Title:

Care Manager I (RN)

Job Location:

Remote- MI

Job Duration: 3 Months

Shift:

8:00 am to 5:00 PM EST

Description

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. Bachelor's degree in Nursing preferred. 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred. Florida residency required. 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.

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