Nurse Case Manager II

Job Title: Nurse Case Manager II
Location: Franklin, Union, Delaware, Pickaway, and Madison Counties, OH
Travel: Up to 75% travel for member-facing visits (documentation completed at home)
Duration: 2 Months+ (Possible Extension)

Pay Rate: $35.95/hr. on W2
 
Position Summary:
The Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy to meet an individual’s benefit plan and/or health needs. This is achieved through communication and the use of available resources to promote optimal, cost-effective outcomes.


Requires: RN with unrestricted active license.
 
Duties:

• Conduct comprehensive assessments of referred member’s needs and eligibility using clinical tools and data review.
• Determine approach to case resolution or meeting member needs by evaluating benefit plans and available internal/external programs and services.
• Apply and interpret applicable criteria, guidelines, standardized case management plans, policies, procedures, and regulatory standards to ensure appropriate benefits administration.
• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines, as well as company policies and procedures.

 
Experience Required:

• Minimum 3 years clinical practice experience (hospital, home health, ambulatory care, or alternative care settings).
• Experience in healthcare and/or managed care industry.
• Case management experience preferred.
• Proficiency with computer skills including navigating multiple systems and keyboarding.
• Effective verbal and written communication skills.
• Ability to multitask, prioritize, and adapt in a fast-paced environment.
• Sedentary work involving extended periods of sitting, talking on the phone, and typing.
• Ability to perform close inspection of handwritten and computer-generated documents as well as monitor screens.
• Typical office working environment with productivity and quality expectations.

 
Education:

• RN with current unrestricted state licensure required.
• Case Management Certification (CCM) preferred.