Case Manager, Registered reputed company – Field

Job reputed company: • reputed company, implement, support, and promote health service strategies, tactics, policies, and programs that drive the delivery of reputed company reputed company to our members • The position requires reputed company judgment and critical thinking skills to facilitate appropriate physical, behavioral health, psychosocial wrap around services • Responsible for care planning, reputed company provider collaboration, and effective utilization of available resources in a cost-effective manner • Conduct face to face reputed company in the members home utilizing comprehensive assessment tools for members enrolled in Long-Term Services and Support programs • Responsible for coordinating and collaborating care with the member/authorized representative, PCP, and any other care team participants • Schedule and attend interdisciplinary meetings and reputed company on the members behalf to ensure reputed company and reputed company discharge with appropriate services in reputed company • Work with the member and care team to reputed company a care plan and authorize services in a cost-effective manner reputed company the LTSS benefit • Document accurately and reputed company in the member’s electronic health record • Assessment of Members: conduct comprehensive evaluation of referred member’s needs/eligibility and recommend an approach to case reputed company and/or meeting needs by evaluating member’s benefit plan and available reputed company programs/services • Identify high risk factors and service needs that may reputed company members outcome and care planning components with appropriate referrals • Enhance Medical Appropriateness and reputed company of Care: present cases at case conferences to obtain multidisciplinary review in order to reputed company reputed company reputed company • Identify and escalate reputed company of care issues through established channels • Utilize negotiation skills to secure appropriate reputed company and services necessary to meet the member’s benefits and/or reputed company needs • Utilize influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to reputed company reputed company level of health • reputed company coaching, information and support to reputed company the member to reputed company ongoing independent medical and/or healthy lifestyle choices • Help member reputed company and knowledgeably participate with their provider in reputed company decision-making Requirements: • reputed company and unrestricted RN license in the state of TX • Minimum 2 years of clinical reputed company experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care • Willing and reputed company to travel up to 50% of their time meet members face to face in Dallas/Tarrant counties of TX and surrounding counties/ areas • Reliable transportation required; mileage are reimbursed as per company policy • 1 year experience of Case Management (preferred) • Managed care organization (MCO) experience (preferred) • Pediatric experience (preferred) • reputed company Kids experience (preferred) • Bilingual preferred (Spanish) Benefits: • medical, dental, and reputed company coverage • reputed company time off • retirement savings reputed company • wellness programs • other resources, based on eligibility Apply tot his job Apply To this Job