Case Manager

2 days ago

Plymouth Meeting, Pennsylvania, United States Progenyhealth Full time

ProgenyHealth is a company specializing in care management solutions for infants in intensive care nurseries.   We partner with health plans and employer groups and their neonatal providers to work collaboratively in developing a plan of care specific to the needs of each child. We work with the plans' neonatal providers and families from the moment an infant is admitted to the intensive care nursery, until they are safely transitioned from the hospital through the first year of life.

We have Full-time positions available for both Clinical Care and Case Management.  These positions are located in Plymouth Meeting, PA and are on-site positions.  Responsibilities include:

  • Initiating the continuum of care process for neonatal admissions;
  • Act as a member advocate by the appropriate selection of services, appropriate utilization of resources and providing an ongoing evaluation of patient outcomes
  • work in a telephonic managed care setting combining strong clinical knowledge and critical thinking to facilitate a care plan that will ensure quality medical care for the high risk member population serviced by ProgenyHealth Inc.
  • develop care plans individualized to the needs of each infant and their family

Requirements:

  • Registered Nurse (RN) with a current, unrestricted license is required.

  • Three or more years of clinical experience as a NICU/pediatric nurse required.

  • Two or more years of managed care experience in a hospital, integrated health system or health plan in a concurrent review and discharge planning role is preferred.

  • Data entry skills required. Must be computer literate.

  • Case management/managed care experience is a plus.

  • CCM certification highly desirable.

  • Excellent communication skills and organizational ability is required.

  • Must be self-motivated and willing to learn multiple tasks. Must be well organized and able to prioritize tasks.

  • Must demonstrate accuracy in spelling and documentation. Proficiency in a second language is highly desirable.

  • Ability to perform job functions with autonomy and be a self starter. Must possess excellent interpersonal skills, telephone etiquette and maintain positive communication at all times.

  • Must have commitment to excellence in customer service.

ProgenyHealth is an Equal Opportunity Employer

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