Jobs

    Clinical - Care Manager II (RN) San Antonio - Texas, United States - Media Riders Inc.

    Media Riders Inc.
    Media Riders Inc. Texas, United States

    2 weeks ago

    Default job background
    Description

    **Remote in San Antonio Texas**

    ***MUST LIVE IN SAN ANTONIO AND SURROUNDING AREAS***

    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. Care Manager would be responsible to complete 6 assessments per week with our members in their home. Our position is with the Assessment Team and we are the ones to complete initial assessments for new members and we also complete reassessments for Level 3 members (low acuity). Our team also completes Medically Dependent Children's Program Interest List assessments.

    Describe the performance expectations/metrics for this individual and their team:

    • Attend onboarding training
    • Complete 4-6 weeks of shadowing with a preceptor/tenured staff
    • Independently complete 6 visits/assessments within a weeks' time frame and all applicable documentation required by contract.
    • Assessment can take 2-4 hours
    • Documentation can take 1-2.5 hours
    • Submit all required documentation within the 5BD time frame unless otherwise indicated for 3BD
    • Complete all trainings on time
    • Attend all team meetings

    Tell me about what their first day looks like:

    • Sign in and join an IT meeting for 30-45min at 830. Set up profile for beeline and begin on training modules

    What previous job titles or background work will in this role?

    • Private duty nursing
    • Home Health

    Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's 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.

    Licenses/Certifications: Current state's RN license.

    Texas Requirements:

    Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's 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.


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