Rn, case manager
2 weeks ago
Case Manager (RN)
The Case Manager applies a collaborative process of assessment, planning, facilitation, and advocacy to support members in accessing appropriate services aligned with their benefit plan and health needs. Through effective communication and coordination of available resources, this role promotes optimal, cost-effective outcomes. An active, unrestricted RN license is required. Experience with case management and Illinois waiver services is preferred.
Key Responsibilities:
Conduct comprehensive assessments of referred members' needs and eligibility using clinical tools, data review, and evaluation of benefit plans and available internal/external programs and services.
Apply and interpret applicable criteria, guidelines, standardized case management plans, policies, procedures, and regulatory standards to ensure appropriate administration of benefits.
Utilize case management and quality management processes in accordance with regulatory and accreditation requirements, as well as company policies and procedures.
Collaborate virtually with internal teams and work independently in a home-based environment, using digital tools to communicate and coordinate care.
Qualifications:
Registered Nurse (RN) with an active, unrestricted Illinois license (REQUIRED)
Case Management Certification (CCM) preferred
Minimum 3-5 years of clinical practice experience preferred
Minimum 2-3 years of care management, discharge planning, and/or home health care coordination preferred
Comfortable working from home, independently, and using technology for collaboration
Schedule:
Monday-Friday, 8:00 a.m. to 5:00 p.m. CST
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
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