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    Care Manager II - Indianapolis, United States - BCFORWARD TECHNOLOGIES PRIVATE LIMITED

    BCFORWARD TECHNOLOGIES PRIVATE LIMITED
    BCFORWARD TECHNOLOGIES PRIVATE LIMITED Indianapolis, United States

    3 weeks ago

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    Description

    BC Forward is looking for *Care Manager II (RN) (Remote Work) * in *Indianapolis, IN 46204**About BCforward*Established in 1998, BCforward, a Black-owned firm headquartered in Indianapolis, IN, pioneers workforce management and digital product delivery solutions globally.

    With a team of 6,000+ consultants across the world, they champion human potential, guided by core values of People-Centricity, Excellence, and Diversity.

    As a market leader, BCforward provides a best-in-class workplace, emphasizing equal opportunity employment and fostering a culture of accountability and optimism.

    *Position Title: Care Manager II (RN) (Remote Work)

    *Mode of Work: REMOTE Indiana - EST**Locations: 550 North Meridian Street, Indianapolis, IN 46204**Anticipated Start Date: 6/10**Expected Duration: 12 months**Job Type: Contract to Hire**Shift: Monday thru Friday 8 am to 5 pm, Training 8-5 EST - 120 days**Pay Rate: $50.00/hr on W2**Note : Must have Active Indiana RN License and expertise in Registered Nurse - OB (Prenatal, Postpartum and/or Labor and Delivery experience)


    Job Description:

    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.

    Provide Care Management duties to include telephonic outreach to high risk OB members, assess members for complex medical needs, develop and update care plans, assess members current health , resource utilization, assess progress to goals, assist member with coordinating services and appointments, provide member education, assist with access to community based services, participate in care management rounds,

    • Case load expectation = 50 with an expected minimum of 5 enrollments a month for caseload building
    • Quality Charting meeting NCQA standards with expectations of monthly audits at 94% or higher.
    Tell me about what their first day looks like:

    • The first day at MHS will include a Welcome call from your supervisor and preparing for the Learning Journey. The preparation for this includes setting up home office, computer applications, setting up equipment, downloading materials and watching videos to prepare for upcoming trainings.

    Required Skills/Experience:
    Registered Nurse - OB (Prenatal, Postpartum and/or Labor and Delivery experience)


    Preferred Skills/ Experience:
    Case Management 1+ years

    Telephonic outreach experience

    Medicaid experience

    Education/Experience:
    Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred.

    2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting.

    Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.

    Education Requirement:
    Active Indiana Registered Nurse License


    Education Preferred:
    BSN, CCM


    Licenses/Certifications:
    Current states RN license.


    Texas Requirements:

    Education/Experience:
    Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting.

    2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment.

    Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.


    Licenses/Certifications:
    Current states RN license.


    For New Hampshire Healthy Families:

    Candidates with active RN license in good standing in other states than NH, must obtain the NH RN equi within 90 days of hire.

    Active drivers license in good standing preferred. CCM preferred.

    For Arizona Complete Health - Complete Care plan:
    Pediatrics assignments require 2+ years RN experience in pediatrics (clinical acute care, community or managed care setting) and 1+ year experience in care management

    Obstetrics (OB) assignments require 2+ years RN experience in OB (clinical, acute, community or managed care setting) and 1+ year experience in care management


    Licenses/Certifications:
    Current states RN license.


    For Buckeye Community Health Plan:

    Education/Experience:
    Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred.

    2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management or utilization experience in a managed care setting.

    Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.


    Licenses/Certifications:
    Current states RN license.


    For Michigan Complete Health:
    Licensed registered nurse; licensed nurse practitioner; licensed physician's assistant. Valid driver's license required.


    • 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
    • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
    • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
    • 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.
    • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
    • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
    • Direct care to participating network providers
    • Perform duties independently, demonstrating advanced understanding of complex care management principles.
    • Participate in case management committees and work on special projects related to case management as needed
    • For New Hampshire, Massachusetts, & Michigan Complete Health - home visits required

    Job Types:
    Full-time, Contract


    Pay:
    From $40.00 per hour

    Expected hours: 40 per week


    Benefits:

    • 401(k)
    • 401(k)
    matching

    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Monday to Friday

    Work setting:

    • Hybrid work

    Ability to Relocate:

    • Indianapolis, IN 46204: Relocate before starting work (Required)

    Work Location:
    Hybrid remote in Indianapolis, IN 46204
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