Senior Registered Nurse Case Manager

Job Description

Job Description

Immediate need for a talented Senior Registered Nurse Case Manager. This is a 06+months contract opportunity with long-term potential and is located in Durham, NC(Onsite). Please review the job description below and contact me ASAP if you are interested.

Job ID: 26-31454

Pay Range: $30/hr - $37/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Serve as a team member on a multidisciplinary team, coordinating care, resources, and services for members to achieve optimal clinical and resource outcomes.
• Utilize applicable clinical skillset and perform comprehensive assessments to collaborate with members, families, internal partners, and external providers on treatment plans.
• Develop a member-centric plan tailored to individual needs, health status, and support requirements; identify barriers to achieving goals.
• Utilize community resources and funding sources in the development of care plans.
• Perform ongoing monitoring and management of members, including scheduled follow-ups and assessments of progress towards goals.
• Evaluate and facilitate care provided through various settings, including physician offices, hospitals, and home care.
• Educate members and encourage proactive interventions to limit expenses and promote positive outcomes.
• Document all aspects of the care plan from initial assessment to outcome evaluation.
• Outreach to high-risk, high-cost, or high-utilization members as needed.
• Review alternative treatment plans and assess benefits eligibility.
• Evaluate medical necessity and appropriateness of services as defined by department standards.
• Develop relevant policies, procedures, and training materials as needed.

Key Requirements and Technology Experience: 

• RN license in North Carolina with 3+ years of clinical and/or case management experience required.
• Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure).
• For some roles, additional specialty certification (i.e., CCM, CDCES) may be required within 2 years of employment.
• Nice to have: Master’s in Social Work with 5 years of related experience; applicable licensure for Behavioral Health roles with a minimum of 3 years of clinical experience.

Our client is a leading Insurance Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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