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RN Case Manager

RN Case Manager

Apidel TechnologiesCincinnati, OH, US
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Job Description

Position : Nurse Case Manager II

Location : Hybrid in Ohio, Florida and Illinois

Duration : 03-06 Months (with possibilities of extension)

Shift : 8am-5pm Monday through Friday

  • This role is hybrid, with 50%-75% travel required for in-person meetings within the Service Delivery Area

Position Summary

  • The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and / or health needs through communication and available resources to promote optimal, cost-effective outcomes.
  • Duties

  • Through the use of clinical tools and information / data review, conducts comprehensive assessments of referred member's needs / eligibility and determines approach to case resolution and / or meeting needs by evaluating member's benefit plan and available internal and external programs / services
  • Application and / or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and / or member’s needs to ensure appropriate administration of benefits.
  • Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
  • Experience

  • 3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
  • Healthcare and / or managed care industry experience.
  • Case Management experience preferred Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
  • Effective communication skills, both verbal and written.
  • Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
  • Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
  • Work requires the ability to perform close inspection of hand written and computer-generated documents as well as a PC monitor.
  • See members in their home and documentation from home office.
  • Education

  • RN with current unrestricted state licensure.
  • Case Management Certification, CCM preferred.
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    Rn Case Manager • Cincinnati, OH, US