Job Description
Job Description
Shedule:Mon-Fri 8am to 5 pm
Description - This position is working remotely and will require home visits and possible visits to Nursing Facility.
- Local travel: 50-75% Territory includes Dallas, Ellis, Navarro, Kaufman, Rockwall, Hunt, Collin and/ or Tarrant coun
- Case load: 60-95
- please add to resume: RN with current unrestricted state licensure, and location
- please ensure that the candidate is comfortable driving, this role requires travel up to an hou
- - Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
- - Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
- - Services strategies policies and programs are comprised of network management and clinical coverage policies.
- - Coordinates and implements assigned care plan activities and monitors care plan progress
- - Conducts multidisciplinary review in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels
- - Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
- - Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
- - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
- - Helps member actively and knowledgeably participate with their provider in healthcare decision-making
- - Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
- Enable Skills-Based Hiring No Qualification
Duties - This position is work from home and will require home visits and possible visits to Nursing Facility. Local travel: 50-75% Territory includes Dallas, Ellis, Navarro, Kaufman, Rockwall, Hunt, Collin and/ or Tarrant county - Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
- Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. - Services strategies policies and programs are comprised of network management and clinical coverage policies. - Coordinates and implements assigned care plan activities and monitors care plan progress
- Conducts multidisciplinary review in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels - Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
- Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices - Helps member actively and knowledgeably participate with their provider in healthcare decision-making - Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Experience - License Registered Nurse
- 3+ years clinical practice experience
- 1+ year Case Management experience
Position 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. Requires an RN with unrestricted active license
Education : RN with current unrestricted state licensure.
Employment Type: Full Time
Salary: $38 - $39 Hourly
Bonus/Commission: No
Job Tags
Hourly pay, Full time, Temporary work, Local area, Remote work,