- Develop, assess, and adjust, as necessary, the care plan and promote the desired outcome
- Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long-term goals, treatment and provider options
- Coordinate services between Primary Care Physicians (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
- Develop a plan of care based upon assessment with specific objectives, goals, and interventions designed to meet member's needs
- Provide patient and provider education
- Facilitate member access to community-based services
- Monitor referrals made to community-based organizations, medical care, and other services to support the members' overall care management plan
- Actively participate in integrated team care management rounds
- Identify related risk management quality concerns and report these scenarios to the appropriate resources
- Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
- Registered Nurse, 5 plus years of clinical RN experience
- Medicare Case management experience
- Compact License
- CCM certification
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Care Manager I - Orlando, United States - Spectraforce Technologies
Description
Care Manager I (RN)02 months
60-day contract position. Compact License
Licenses/Certifications:
Current state's RN license.
Remote (Florida residency is required.)
Position Purpose:
Perform care management duties to assess, plan, and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost-effective care
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred.
2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.
Knowledge of healthcare and managed care preferred. Prior experience working in a remote role is preferred.
Prior case management experience is preferred. Bilingual in Spanish and English is preferred.
Licenses/Certifications:
Current state's RN license.
Required Skills/Experience:
Preferred Skills/ Experience:
*Work-from-home case management role
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