Clinical - Care Manager I (RN)

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