Telephonic Case Manager

Market leading healthcare organization looking for hybrid RN Case Manager in greater Lynchburg, VA area! Great opportunity, call us today!

Hybrid role with a blend of working from home and traveling in the field.

Candidate must reside in Virginia and will be covering the Lynchburg area (will be reimbursed for mileage).

Duties:

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.

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:

Requires an RN in NC with unrestricted active license

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-

Shift: Monday-Friday 8:00am - 5:00pm EST.

No nights, no weekends, no holidays and no on-call

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on randstadusa.com.


Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).


This posting is open for thirty (30) days.