RN Case Manager

Shedule:Mon-Fri 8am to 5 pm

Description

• This position is working remotely and will require home visits and possible visits to Nursing Facility.
• Local travel: 50-75% Territory includes Dallas, Ellis, Navarro, Kaufman, Rockwall, Hunt, Collin and/ or Tarrant coun
• Case load: 60-95
• please add to resume: RN with current unrestricted state licensure, and location
• please ensure that the candidate is comfortable driving, this role requires travel up to an hou
• - Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.

• - Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
• - Services strategies policies and programs are comprised of network management and clinical coverage policies.
• - Coordinates and implements assigned care plan activities and monitors care plan progress
• - Conducts multidisciplinary review in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels
• - Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
• - Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
• - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
• - Helps member actively and knowledgeably participate with their provider in healthcare decision-making
• - Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
• Enable Skills-Based Hiring No Qualification

Duties :

• This position is work from home and will require home visits and possible visits to Nursing Facility. Local travel: 50-75% Territory includes Dallas, Ellis, Navarro, Kaufman, Rockwall, Hunt, Collin and/ or Tarrant county - Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
• Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration. - Services strategies policies and programs are comprised of network management and clinical coverage policies. - Coordinates and implements assigned care plan activities and monitors care plan progress
• Conducts multidisciplinary review in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels - Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health - Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices - Helps member actively and knowledgeably participate with their provider in healthcare decision-making - Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Experience :

• License Registered Nurse
• 3+ years clinical practice experience
• 1+ year Case Management experience

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

Education : RN with current unrestricted state licensure.