Overview Join to apply for the Nurse Case Manager II role at Apidel Technologies
Locations include Franklin, Union, Delaware, Pickaway, and Madison Counties for in person visits with up to 75% travel. Documentation at home may be required.
Responsibilities 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. Requires an RN with unrestricted active license.
Using 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 the member\'s benefit plan and available internal and external programs/services.
Applies 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 and Qualifications Clinical practice experience in a hospital setting or alternative care setting such as home health or ambulatory care is required.
Healthcare and/or managed care industry experience.
Case Management experience preferred; position requires proficiency with computer skills including 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; ability to sit for extended periods and use a PC.
Ability to perform close inspection of handwritten and computer-generated documents as well as monitor display.
RN with unrestricted active license; Case Management Certification (CCM) preferred.
Education RN with current unrestricted state licensure.
Case Management Certification CCM preferred.
Schedule 8am-5pm Monday through Friday
Seniority level Entry level
Employment type Full-time
Job function Health Care Provider
Industry Staffing and Recruiting
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