Nurse Case Manager II

SGS Consulting; Columbus (OH); On-site; USD 65,000 - 90,000; Full time

Job summary

SGS Consulting is seeking a Case Manager to support healthcare and managed care initiatives in Columbus, OH. The role emphasizes assessment of member needs, eligibility, and navigating benefit plans and external programs to resolve cases.

Qualified candidates will be an RN with active licensure and preferred case management experience. Strong computer skills and ability to review clinical data are essential.

Qualifications

• RN with current unrestricted state licensure.
• Case management experience preferred.

Responsibilities

• Healthcare and/or managed care industry experience.
• Case Management experience preferred.
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
• Using 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.

Skills

Case management

Collaboration

Assessment

Education

RN license

Case management experience preferred

Job description

Job Responsibilities:

• Healthcare and/or managed care industry experience.
• Case Management experience preferred.
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
• Using 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

Skills:

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.

Education/Experience:

• RN with current unrestricted state licensure.
• Preferred case management experience