Nurse Case Manager II

Integrated Resources, Inc ( IRI ); Missouri; Remote; USD 60,000 - 90,000; Full time

Job summary

A prominent organization is seeking a Nurse Case Manager II to work remotely in Missouri. This role involves assessment, planning, and advocacy to meet individual health needs efficiently. Candidates should have clinical practice experience and an active RN license in Missouri. The position is expected to last 5-6 months, with potential for extension.

Qualifications

• 2-3 years clinical practice experience in a hospital or alternative care setting.
• Healthcare and/or managed care industry experience required.
• Case management experience preferred.

Responsibilities

• Conduct comprehensive assessments of referred members' needs.
• Evaluate members' benefit plans and assess appropriate services.
• Utilize quality management processes in compliance with guidelines.

Skills

Effective communication

Multitasking

Proficiency with computer skills

Education

RN with current unrestricted MO state licensure

Case Management Certification (CCM)

Job description

2 days ago Be among the first 25 applicants

Job Title: Nurse Case Manager II

Job Location: Remote, MO

Job Duration: 5-6 Months(possibility of extension)

• 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.
  
  

Job Title: Nurse Case Manager II

Job Location: Remote, MO

Job Duration: 5-6 Months(possibility of extension)

Job Summary:

• 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.
  
  

Duties:

• 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.
  
  

Experience:

• 2-3 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.
  
  

Knowledge, Skills and Abilities:

• 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
  
  

Certification / License:

• RN with current unrestricted MO state licensure.
• Case Management Certification (CCM) preferred.
  
  

Interview:

• 30 minute MS team interview.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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