Field/Telephonic Nurse Case Manager

Job Description

Job Description

Here are the job details for your review:

Job Title: Nurse Case Manager II

Job Location-Norfolk/Virginia Beach, VA

Duration: 6+ Months (Potential for Extension)

Pay Rate: $44.12/HR on W2         

Shift: Mon-Fri 8:00-5:00pm

Candidate must reside in Virginia. (Need to reside is one of these locations: Norfolk/Virginia Beach)

Add city, state, zip and county at the top of your resume.

Telephonic and Field work. Candidates will need a quiet, dedicated work space with no distractions. Must have an active and unrestricted RN license in the state of Virginia or compact license.

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

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
Will be expected to travel to various hospital faciliteis to meet with members and hospital staff. Will collaborate with the assigned case manager to report visit finidngs.

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?

Education:

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