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Posted about 1 month ago
Requirements and responsibilities
Job Title: Nurse Case Manager - Michigan
Duration: 4 plus month with possible extension
Location: Michigan (Fully remote)
Pay Range: $40-$45.00/hr
Standard business hours: Monday - Friday 8:00 am - 5:00 pm EST.
Primarily telephonic. No field work needed for this role.
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.
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.
-Experience managing chronic conditions, such as diabetes, hypertension, and asthma.
-Experience preferred managing the CSHCS population (Children's Special Health Care Services)
-Healthcare and/or managed care industry experience required.
-Case Management experience required -- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Optionally, you can add more information later (benefits, pre-screening questions, etc.)