Clinical - Care Manager I (RN)

MWIDM; Lauderhill (FL); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a dedicated Care Manager to enhance the quality of healthcare for members. In this pivotal role, you will assess, plan, and coordinate comprehensive care services, ensuring that patients receive the support they need across the healthcare continuum. Your expertise in clinical nursing and care management will be crucial in developing tailored care plans and facilitating access to community resources. Join a dynamic team that values collaboration and innovation, and make a meaningful impact in the lives of those you serve while enjoying a flexible work environment.

Qualifications

• 2+ years of pediatric clinical nursing experience in various settings.
• Knowledge of healthcare and managed care is preferred.

Responsibilities

• Assess and coordinate medical services for members to promote quality care.
• Develop and adjust care plans based on individual member needs.

Skills

Care Management

Patient Education

Clinical Assessment

Community Resource Coordination

Bilingual (Spanish and English)

Education

Bachelor’s degree in Nursing

Graduate from an Accredited School of Nursing

Tools

Medical Management Systems

Job description

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Overview

• External Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
• Develop, assess and adjust, as necessary, the care plan and promote desired outcomes.
• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options.
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.
• Develop a plan of care based upon assessment with specific objectives, goals, and interventions designed to meet member's needs.
• Provide patient and provider education.
• Facilitate member access to community-based services.
• Monitor referrals made to community-based organizations, medical care, and other services to support the members’ overall care management plan.
• Actively participate in integrated team care management rounds.
• Identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.

Education/Experience

• Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
• 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting.
• Knowledge of healthcare and managed care preferred.
• Florida residency required.
• Prior experience working in a remote role preferred.
• Prior case management experience preferred.
• Bilingual in Spanish and English is preferred.

About the Company

MWIDM Inc. is a WMBE Certified global staffing firm serving Fortune 2000 clients with customized and scalable workforce solutions. With our account management integrated into our delivery process, we provide you with staffing solutions that are transparent and robust irrespective of the industry you function.