Job Duration
2-3 Months (possibility of extension)
Payrate
$35.95 per hour on W2
Job 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.
Responsibilities
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.
Licensure
RN with current unrestricted state licensure.
Certification
Case Management Certification CCM preferred.
Experience
3 years clinical practice experience (e.g., hospital setting, alternative care setting such as home health or ambulatory care).
Healthcare and/or managed care industry experience.
Case Management experience preferred.
Proficiency with computer skills, including navigating multiple systems and keyboarding.
Skills
Effective communication skills, both verbal and written.
Ability to multitask, prioritize and adapt to a fast‑paced, changing environment.
Physical Requirements
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 handwritten and computer‑generated documents, as well as a PC monitor.
Work Environment
Typical office working environment with productivity and quality expectations.