50 to 75% travel required in the area Mileage will be reimbursed.
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or members needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
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Experience : 3+ years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. 3+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 VA state licensure. Associates Degree or Higher
What days & hours will the person work in this position? List training hours, if different. : 8am to 5 pm M-F
Seniority level
Mid-Senior level
Employment type
Contract
Job function
Health Care Provider
Industries
Wellness and Fitness Services, Alternative Medicine, and Hospitals and Health Care
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