RN Case Manager

NA; Orlando (FL); Remote; Full time

Job summary

A leading healthcare provider is seeking a Case Manager to facilitate and advocate for optimal health outcomes. This role involves assessing individual needs, coordinating care, and ensuring effective transitions for members. Candidates must have a valid RN license, clinical experience, and be bilingual in Spanish and English.

Qualifications

• Minimum 2 years of clinical experience required.
• Candidate must reside in FL.
• Willing to travel 75% of the time.

Responsibilities

• Apply critical thinking and clinical criteria for assessments.
• Conduct home assessments and coordinate care plans.
• Work with case managers to identify high-risk members.

Skills

Bilingual Spanish/English

Critical thinking

Evidence-based clinical criteria

Education

Active, unrestricted RN license in Florida

Job description

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Location: Remote + Field Visits (Multiple locations in Florida)

Hours: 40 hrs/Week

Pay Range: $40-42.00/hr. on W2 + Mileage

Job Duration: 6 Months

Shift: Mon - Fri 8am - 5 pm EST

Description:

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.

Responsibilities:

• Apply critical thinking, evidence-based clinical criteria to support contractual rebalancing goals.
• Complete telephone or in-person contact to assess the home prior to discharge and identify any environmental supports needed to support transition (e.g., ramp, DME installation, etc.).
• Conduct an in-person Significant Change Visit with members and representatives if applicable, within 5 days of transition. Coordinate provision of services as needed, establish a Plan of Care, and document all actions taken.
• Work collaboratively with case managers to identify high-risk community members and implement appropriate interventions to prevent lapse or coordinate safe transition (upon receiving referral).
• Drive enhanced value of healthcare to increase member satisfaction and retention, and drive new membership.

Experience Required:

• Candidate must reside in FL.
• Minimum 2 years of clinical experience. Bilingual Spanish/English required.
• Willing and able to travel 75% of their time to meet members face-to-face and surrounding counties/areas.
• Preferred Skills: Managed Care Experience, Discharge Coordination Experience, Transition of Care Experience, Home Health Experience, Case Management Experience.

Education:

• Active, unrestricted, and good standing RN license in the state of Florida.

Seniority level

• Entry level

Employment type

• Contract

Job function

• Health Care Provider