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    Care Manager I - Jacksonville, United States - Spectraforce Technologies

    Spectraforce Technologies
    Spectraforce Technologies Jacksonville, United States

    2 weeks ago

    Default job background
    Description
    Care Manager I (RN)

    03 months

    Compact License

    Remote 100%


    Licenses/Certifications:
    Current state's RN license.

    Remote, compact state needed with NY licensure.


    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 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

    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.

    Remote, compact state needed with NY licensure.


    Required Skills/Experience:

    Preferred Skills/ Experience:

    • Registered Nurse, 5 plus years of clinical RN experience
    • Medicare Case management experience
    • Compact License
    • CCM certification preferred
    *Pediatrics - birth to 21

    *Work-from-home case management role
    #J-18808-Ljbffr
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