Location : Dallas, TX
Shift : am-pm, No OT
Duration : + months, possible temp to perm
Job Description : Position Purpose :
Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex / high acuity populations with primary medical / physical health needs to promote quality, cost effective care.
Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families / caregivers on services and benefit options available to receive appropriate high-quality care.
Education / Experience :
Requires Graduate from an Accredited School or Nursing or a Bachelor's degree and years of related experience
Bachelor's degree in Nursing preferred
License / Certification :
RN - Registered Nurse - State Licensure and / or Compact State Licensure required or
NP - Nurse Practitioner - Current State's Nurse Licensure required
Resource Utilization Group (RUG) certification required at time of hire.
Walk me through the day to day responsibilities of this the role and a description of the project :
Work in community assessing members doing Waiver Assessments, coordination of services for members, communication with providers and shareholders, authorization requests and follow ups
Describe the performance expectations / metrics for this individual and their team :
Conduct nursing assessments, documentation, and follow ups correctly and timely
Required Skills / Experience : Preferred Skills / Experience : . Communication skill, . Community based care management .
Organization . Hospital . Communication skills . Critical care Education Requirement : RN Education Preferred : Software Skills Required : Excel, word, computer Required Certifications : RUG can be obtained upon hire Required Testing : RUG
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