RN Case Manager

Up to $44.14 per hour Fairfax County, VA Onsite Share on Job Description Our Client, a Retail Pharmacy, is looking for a RN Case Manager to work in Fairfax County, VA (Arlington, Falls Church, Vienna or Annadale). Responsibilities: 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. 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 Requirements: 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 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 Requires an RN with unrestricted active license in the state of VA or a compact license. Case Management Certification CCM preferred. Why Should You Apply? Health Benefits Referral Program Excellent growth and advancement opportunities #mcb

#INDHOT