Location: Des Moines, IA
Registered nurse needed for REMOTE Case Manager position in Iowa! Must reside in the state of Iowa. This job is moving fast so send your resume to firstname.lastname@example.org for quickest response.
Contract length: 6+ months
Location: Must reside in Iowa.
- Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning.
- Ensures member access to services appropriate to their health needs.
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
- Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
- Works with team to develop treatment plans.
- Negotiates rates of reimbursement, as applicable.
- Assists in problem solving with providers, claims or service issues.
- BA/BS in a health related field; 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted RN license in applicable state(s) required.
- Multi-state licensure is required if this individual is providing services in multiple states.
- Certification as a Case Manager is preferred.
- Ability to investigate clinical notes and understand member needs/contact info, etc.
- Strong computer skills
- Medicaid experience preferred
- Previous MCO experience preferred
- Wide variety of clinical experience preferred
It's probably safe to say you're interested if you made it far. Go ahead and send your updated resume to email@example.com or share this job with your network.
I look forward to hearing from you!
Direct line: 484-434-2946
Recruiter, The Judge GroupContact:
This job and many more are available through The Judge Group. Find us on the web at www.judge.com