50% Remote + 50%Travel Job Role of 'Nurse Case Manager II' in SW Michigan OR Wayne OR Macomb County, MI

Remote, USA Full-time
Job Description : Job ID : 26-04245 Job Title : ‘Nurse Case Manager II’ Estimated Length of Assignment : 03+ Months with Possible Extension (The dates provided are only an estimate and not a guarantee) Negotiable Estd. Pay Range - $40.00 / Hour to $44.14 / Hour on W2 (USD) –All Inclusive Work Type : 50% travel / 50% work at home in SW Michigan (Counties : Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties OR Wayne OR Macomb County, MI) Schedule –Monday-Friday 8am-5pm EST Field and Telephonic Add city / state, zip and county at the top of the resume Candidates should be either in one of these counties or very close to it. They will be traveling to this region. Sourcing for SW Michigan (1 County : Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties OR Wayne OR Macomb County, MI) Duties : • 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 Experience : • 3 years Clinical practice experience, e.G., hospital setting, alternative care setting such as home health or ambulatory care required. • Healthcare and / or managed care industry experience. • Case Management experience preferred Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding • Effective communication skills, both verbal and written. • Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment • Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. • Work requires the ability to perform close inspection of hand written and computer-generated documents as well as a PC monitor. • Typical office working environment with productivity and quality expectations? Position Summary : 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. • Requires an RN with unrestricted active license for MI. • Requires an RN with unrestricted active license • RN with current unrestricted state licensure for MI. • Case Management Certification CCM preferred Apply tot his job
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