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Nurse Case Manager II

Iconma Portal
6 days ago
Remote
$16 - $39.86 USD hourly
Case Management
Our Client, a Retail Pharmacy company, is looking for a Nurse Case Manager II for their Remote location.
 
Responsibilities:
  • 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-- 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.
  • RN with current unrestricted state licensure in West Virginia or a compact state.
  • Associate’s of Science in Nursing (ASN) degree and relevant experience in a health care-related field (REQUIRED)
  • Bachelor’s of Science in Nursing (BSN) (PREFERRED)
  • Case Management Certification CCM preferred
 
Why Should You Apply?