About the job
Job Title: RN Nurse Case Mg
Duration: 7+ Months
Location: Indianapolis, IN (Remote)
Job Type: Contract (40 hrs. a week)
Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.)
Description:
- Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum.
- Performs duties telephonically or on-site such as at hospitals for discharge planning.
- Primary duties may include but are not limited to: Ensures member access to services appropriate to their health needs.
- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
- Coordinates internal and external resources to meet identified needs. Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
- Negotiates rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues.
- Requires BA/BS in a health-related field and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
- Current, unrestricted RN license in applicable state(s) required.
- Multi-state licensure is required if this individual is providing services in multiple states.
- Certification as a Case Manager is preferred.
- For URAC accredited areas the following applies: Requires BA/BS and 3 years of clinical care experience; or any combination of education and experience, which would provide an equivalent background.
- Current and active RN license required in applicable state(s).
- Multi-state licensure is required if this individual is providing services in multiple states.
- Certification as a Case Manager and a BS in a health or human services related field preferred.
If you are interested, please feel free to send me your details or contact me directly. [email protected] OR (317)- 315-8944