Nurse Case Manager II in Orange-Osceola-Brevard-Seminole Counties, FL

Job Description

Job ID: 26-71728
Job Title: ''Nurse Case Manager'
Position Type: Full-Time Contract Role
Location: Orange-Osceola-Brevard-Seminole Counties, FL
Work Type: 75% Travel + 25% Remote
Est. Pay Range: $35.00/Hour to $38.00/Hour on W2 (USD)
Schedule: Monday - Friday 8 am to 5 pm


Candidate must reside in Orange-Osceola-Brevard-Seminole Counties and will service Orange-Osceola-Brevard-Seminole and be able to travel to facilities/homes within the regions/neighboring counties. Hours required are M - F 8am - 5 pm EST with some flexibility for start/ stop times. Local travel up to 75%. Applies critical thinking, evidence-based clinical criteria to support contractual goals.


Duties:

• Coordinates case management activities for Medicaid Long Term Care/Comprehensive Program enrollees.
• Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.
• Conducts comprehensive evaluation of Members using care management tools and information/data review
• Coordinates and implements assigned care plan activities and monitors care plan progress
• Conducts multidisciplinary review 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:

• 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


Education:
RN with current unrestricted state licensure.
Case Management Certification CCM preferred

Meet Your Recruiter

Mahendra Tomar