RN Case Manager

Chembular Manpower

Salem (NH)

On-site

USD 70,000 - 95,000

Full time

14 days+

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Job summary

A staffing agency in Salem, NH seeks a qualified Case Manager. The ideal candidate will possess an RN Degree and have 3-5 years of case management experience. Responsibilities include advocating for clients, engaging in case management processes, and ensuring comprehensive healthcare delivery. Excellent communication and case management certification are required. Candidates must be local or within the region. Competitive salary based on experience.

Qualifications

Current NH/PA RN license is required.
3 years medical/surgical experience is necessary.
Demonstrated success as a case manager is essential.
Excellent written and oral communication skills.
Proficiency in Word and Excel.
Knowledge of the insurance industry, benefits, claims processing.
Ability to apply CMSA standards and guidelines.

Responsibilities

Act as an advocate for clientele in various levels of wellness.
Engage ethically in the case management process.
Interact with all healthcare systems to meet individual needs.
Utilize resources and funding to maximize benefits.
Document goals, outcomes and cost-benefit analyses.
Collaborate with Utilization Review and care teams.

Skills

Communication skills

Case Management certification

Managed Care Software knowledge

Intermediate Word and Excel skills

Knowledge of insurance industry

Education

RN Degree or Diploma

3-5 years case management experience

Case Management certification (CCM)

Tools

Utilization Review software

Job description

TFA Staffing Co.is a full service professional staffing agency.We specialize in the High Technologyprofession with talent in many different areas. A faster pace - The average professional at TFA Staffing completes 8 to 12 engagements in a year across numerous areas of practice and client industries. Large Enterprise Clients: Our consultants work on critical projects for some of the world's largest companies. We have a diverse set of clients with an emphasis in Professional and Executive Level, Financial Services, Information Technology, Health Care, Sales, Engineering, Industrial and Skilled Labor. We offer candidates complete confidentiality in their search and provide employers with simple, targeted searches from a database of qualified candidates through partnerships with afilliate companies.

Job Description

2 Positions

Start Date ASAP

Salary - DOE

Location- Salem, NH

United StatesCitizenship Required Yes

Security ClearanceNo

Travel Percent - 0

Relocation Assistance - No

Years Experience - 1

Job Summary:

Through early intervention, the Case Manager will apply the six essential activities of Case Management to assure achievement of an individual's maximum level of wellness. Via appropriate, quality, cost-effective alternative care delivery, the Case Manager will explore community resources and alternative funding in order to maximize health care benefit. The Case Manager will assist an individual to self-direct and self-advocate thus assurance of an informed and empowered healthcare consumer.

Essential Duties and Responsibilities:

Acts as an advocate and approaches clientele, according to his/her level of wellness, handicap, or injury with alternatives which may improve his/her quality of life.
Ethically engages in the six essential activities of the Case Management process in order to assess, plan, implement, coordinate, monitor and evaluate health care delivery.
Applies six components of case management to each of the five core areas: coordination/service delivery, physical/psychological factors, benefit systems and cost analysis, case management concepts and community resources.
Practices case management within the full continuum of care encompassing multiple environments.
Interacts with all healthcare systems and continues involvement with all participants to deal with an individual's broad spectrum of need.
Applies CMSA standards of practice to an individual's holistic, healthcare , occupational, psychosocial, cultural and financial need.
Composes confidential, timely, report mechanisms that clearly document goals, objectives, outcomes and cost benefit analysis.
Acts as a resource to Utilization Review, Behavioral Health, Disability and Case Management team members, committees, clientele and personnel.

Qualifications

Education and/or Experience:

RN Degree or Diploma :current NH/PA license, RN licensure within state of case management practice
3 years medical, surgical clinical experience: 3-5 years case management or disease management experience.
Case Management certification Knowledge and skills:
Excellent written/oral/communication skills.
Intermediate Word, Excel computer skills.
Demonstrated success as a case manager with basic Utilization Review skills, Managed Care Software knowledge.
Knowledge of the insurance industry, benefits coverage and claims processing.
Ability to apply the six components to the five core areas of the case management process.
Knowledge of case management principals, clinical guidelines, and CMSA standards.
Ability to prioritize caseload, combining comprehensive nursing knowledge and skill with cost savings methodology and technique.
Knowledge of health care providers, alternative funding and community resources; ability to prioritize and utilize them efficiently within the benefit plan.
In depth knowledge of nursing care plans/skill and ability to facilitate and coordinate transition of patients with catastrophic injuries/illnesses through cost effective, medically appropriate, alternative levels of care.
Actively serves on an committee.
Participates in in-service/provider education.
Maintains membership and activity in a professional affiliation, i.e. Case Management Society of America, Case Management Society of New England, ANA in order to promote professional development within the industry.