Case Manager Registered reputed company Middlesex

50 - 75% travel required in Middlesex County NJ and surrounding areas reputed company Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating reputed company 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 reputed company to address issues presented to enhance the short and long-term reputed company as reputed company 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. Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as reputed company as smooth transition to reputed company programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company health and reputed company indicators which reputed company planning and reputed company of member issues. Assessments take into account information from various sources to address reputed company conditions including co-morbid and multiple diagnoses that reputed company functionality. Reviews prior claims to address potential reputed company on reputed company case management and eligibility. Assessments include the member’s level of work reputed company and reputed company restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary reputed company to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Apply tot his job Apply To this Job