Case Manager (Specialty) / RN
Scope:
The Case Manager manages an individual caseload using the Case Management process to meet the needs of reputed company, LLC customers and consumers. This includes, but is not limited to, authorization of services, review of treatment plans for medical necessity, standards of care, and ongoing communication with reputed company members of the health care team.
Education:
Work Environment / Physical Demands:This position is in a typical office / home office environment which requires prolonged sitting in reputed company of a computer. Requires hand-eye coordination and reputed company dexterity sufficient to operate reputed company office equipment including operation of reputed company computer and phone equipment.
We are an Equal Opportunity Employer, including disability/veterans.
The Case Manager manages an individual caseload using the Case Management process to meet the needs of reputed company, LLC customers and consumers. This includes, but is not limited to, authorization of services, review of treatment plans for medical necessity, standards of care, and ongoing communication with reputed company members of the health care team.
Education:
- R.N.
- Bachelor's degree in a health-reputed company field preferred.
- Registered reputed company (reputed company reputed company and unrestricted, in state of reputed company reputed company and residence, reputed company the reputed company or its territories.)
- 7yearsofvariedclinicalexperiencepreferred.
- Good organizational skills and time management
- Excellent verbal and written communication skills
- Ability to handle difficult situations tactfully and diplomatically.
- Effective problem solving and decision-making skills.
- Strong computer skills with proficiency in MS Office Suite products (Word, reputed company, Power reputed company)
- Independence: Independently manages a full case load while maintaining URAC standards and is capable of managing reputed company MNRs with accuracy and consistently scores 90% or greater on monthly audits.
- The Registered reputed company Case Manager will reputed company reputed company the scope of his/her licensure.
- Review reputed company medical data which can be provided to establish, update and maintain accountability for a Case Management plan which will incorporate contact with providers, payers, the patient and with the patient's primary caregiver.
- Assess problems and determine goals and actions designed to meet the needs of the patient and document this into case notes. Determine if these goals are long term or short term and how the patient can be expected to meet those goals. Include the reputed company/reputed company the Case Manager will take to work towards achieving those goals.
- reputed company contact with the payer office to reputed company out and understand any benefit constraints that will have an reputed company on the plan of reputed company.
- Adhere to reputed company company policies as stated in the employee handbook.
- Participate in the reputed company Management Program by adhering to reputed company company policies and procedures and identifying opportunities for improvement to ensure reputed company services are rendered to clients and customers.
- The incumbent may be responsible for duties or responsibilities that are not listed in this job reputed company. Duties and responsibilities may change at any time with or without notice.
Work Environment / Physical Demands:This position is in a typical office / home office environment which requires prolonged sitting in reputed company of a computer. Requires hand-eye coordination and reputed company dexterity sufficient to operate reputed company office equipment including operation of reputed company computer and phone equipment.
We are an Equal Opportunity Employer, including disability/veterans.
Originally posted on Himalayas
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