Nurse Case Manager II

SGS_JOB_2041

Nursing

Ohio

Excel filtering

Outlook

Contract - 06+ Months

Location: Butler, Clermont, Clinton, Hamilton, Franklin, Union, Delaware, Pickaway, and Madison & Warren Counties in OHIO – Travel JOB The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Job Responsibilities:

Through the use of clinical tools and information/ data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
? Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate
administration of benefits
? Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Skills:

Minimum 3 years of experience.
Must be flexible and adaptable.
Strong basic computer skills required (Excel filtering, Outlook, email).
Must be comfortable with home visits, nursing facilities, and hospitals.

Education/Experience:

?RN with current unrestricted state licensure and Case Management Certification/ CCM – preferred

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