RN Transplant Case Manager - Las Vegas, NV - Full-time / Part-time

As the RN Case Manager you will be responsible for the management and coordination of Case Management services for members having complex needs and requiring complex services in Transplant Department.  Case Manager works directly with the member, providers(s), facilities and other entities to ensure that the Patient is assisted through all Phases of the Transplant process.  The Case Manager manages members from all fully funded product lines. The Case Manager assesses,plans, implements, coordinates, monitors, and evaluates the options and services required to meet the member's health needs.  It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions andoutcomes.

Responsibilities:

• Coordination of member's care through the health care continuum


• Collaborate with member, provider, facility to obtain best outcome


• Collaborate with internal members of the health care team, to include PCP, FHS, COC and Medical Director


• Communicate/Develop/Implement ongoing plan of care in conjunction with member and providers(s)


• Act as resource to SMA and Network providers, contracted transplant facilities.


• Evaluate, measure and report on outcomes


• Utilize written criteria to approve, pend, and/or send case to medical director for review.
  

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)

Requirements:

• Current and unrestricted RN license in the state of Nevada


• 2+ years case management experience in a managed care environment.


• Diploma or equivalent in nursing


• Managed care experience


• NCQA, CMS and other regulatory agencies.


• Knowledge of patient care delivery in a managed care environment.


• Demonstrates initiative toward problem solving skills.


• Completed preceptor training and has ability to mentor others.


• Basic computer skills.


• Must have excellent oral and written communication skills.


• Proficiently demonstrates the skills of a Case Manager.


• Ability to teach.


• Demonstrates excellence in case management skills.


• Ability to contribute to the organization's efforts to eliminate racial and ethnic disparities in organizational performance.


• Critical Demonstrated critical thinking skills as a case manager and able to formulate innovative plan of care for complex cases.


• Recognizes others deficits and assists to train/motivate improvement in their skill sets
 

Preferred Assets:

• Bachelors degree preferred.


• CCM preferred.


• Trasplant experience preferred


• UNOS experience preferred

key words: RN Case Manager, transplant, RN, Registered Nurse, Case Manager, case management, Las Vegas, NV, United Health Group