Title: Clinical - Care Manager I (RN) Duration: 03 Months Remote - OH Monday - Friday 8 AM - 5 PM EST Description - Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care * Develop, assess and adjust, as necessary, the care plan and promote desired outcome * Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options * Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients * Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs * Provide patient and provider education * Facilitate member access to community based services * Monitor referrals made to community based organizations, medical care and other services to support the members' overall care management plan * Actively participate in integrated team care management rounds * Identify related risk management quality concerns and report these scenarios to the appropriate resources * Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems Qualifications - Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred. Florida residency required. Knowledge of healthcare and managed care preferred. Prior experience working in a remote role preferred. Prior case management experience preferred. Bilingual in Spanish and English is preferred. Licenses/Certifications: Current state's RN license. *Pediatrics - birth to 21 *Work-from-home case management role
Spectraforce Technologies
05/04/2024
Columbus,OH