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    Clinical - Care Manager I (RN) - Columbus, United States - Spectraforce Technologies

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    Description

    Title:
    Clinical - Care Manager I (RN)

    Duration: 03 Months

    Remote - OH

    Monday - Friday 8 AM - 5 PM EST


    Licenses/Certifications:
    Current state's RN license.



    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


    • Develop, assess and adjust, as necessary, the care plan and promote 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 Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
    • Develop 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

    Qualifications -
    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.

    Prior case management experience required.

    Knowledge of healthcare and managed care preferred.

    Florida residency required.

    Knowledge of healthcare and managed care preferred.

    Medicare/DSNP experience

    Telephonic case management experience

    Prior experience working in a remote role preferred.

    Bilingual in Spanish and English is preferred.

    *Pediatrics - birth to 21

    *Work-from-home case management role

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