Clinical Case Manager, RN - N
About The Position
Responsible for managing quality, cost effective care using selective benefits and alternative services best suited for the member. This is a Hybrid position and requires the position holder to reside in Nevada Primary duties may include, but are not limited to: Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs. Supports member or their representative in regard to care, care transitions, and changes in health status. Implements a comprehensive clinical case management plan for each patient. Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed. Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances. Performs admission and concurrent stay reviews on hospitalized patients. Develops and implements discharge planning for patients in conjunction with hospital based case managers. Performs telephonic, fax and/or on-site reviews with skilled nursing facilities, home health agencies or other contracted service agencies to determine need for continued care.
Requirements
- Requires a RN and minimum of 2 years of experience; or any combination of education and experience, which would provide an equivalent background.
- Current unrestricted RN NV license in applicable state(s) required.
- Satisfactory completion of a Tuberculosis test is a requirement for this position.
Nice To Haves
- Bilingual in ether Spanish or Vietnamese is preferred.
Responsibilities
- Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs.
- Supports member or their representative in regard to care, care transitions, and changes in health status.
- Implements a comprehensive clinical case management plan for each patient.
- Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed.
- Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances.
- Performs admission and concurrent stay reviews on hospitalized patients.
- Develops and implements discharge planning for patients in conjunction with hospital based case managers.
- Performs telephonic, fax and/or on-site reviews with skilled nursing facilities, home health agencies or other contracted service agencies to determine need for continued care.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
