Case Manager/RN - Full-time / Part-time

RN/Case Management Opportunity

Job Duties

1. The Case Manager is responsible for managing a continuum of care from admission through discharge for assigned patients. The Case Manager partners with medical staff, utilizes scientific evidence for best practices, relevant data and compliance with the mission/philosophy, standards, goals and core values.
2. Proactively assesses all potential case management and member cases identified from either external or internal sources and actively manages all high risk, high volume cases throughout the continuum of the member's health care needs or until they reach a maintenance mode.
3. Demonstrates a multidisciplinary approach in identifying problems, communication and negotiating with the member's PCP, family members, caregivers, other members of the health care team, community resources and the Health Plans.
4. Participate in the development of patient focused long/short term goals, implementing, evaluating and modifying the care plan.
5. Researches and refers members to sources for alternative funding, community services and other services which may provide support to the patient and family.
6. Tracks all CCS referrals for timely notification of decisions. Assists Medical Director with CCS appeals.
7. Coordinates care for CCS members between PCP, CCS providers and other physicians and providers as needed.
8. Identifies cases for possible peer reviewers to evaluate the appropriateness and necessity of care and or quality of care concerns.
9. Acts as a clinical resource to provide accurate and concise information to claims and other departments within the medical group.
10. Assures referrals are complete and enrollment/eligibility benefits verified, prior to authorizing inpatient and outpatient care.

Education

Must have nursing degree and at least 2 years of related experience

Shift

Full time/part time available

About Aerotek:

Our people are everything. As a Best of Staffing® Client and Talent leader, Aerotek® Inc. has distinguished itself as a leader in recruiting and staffing services, by having a deep understanding of the intersection of talent and business. As a strategic partner to more than 17,000 clients and 300,000 contract employees every year, Aerotek's people-focused approach yields competitive advantages for its clients and rewarding careers for its contract employees. Headquartered in Hanover, Md., Aerotek operates a network of over 230 non-franchised offices with more than 6,000 internal employees dedicated to serving our customers. Aerotek is an operating company of Allegis Group, a global talent solutions provider. To learn more, visit .

Aerotek is acting as an Employment Agency in relation to this vacancy.