About the job
1. “Are you currently licensed as an RN?”
2. “Do you possess experience in remote case management?”
3. “Is your RN license a Compact License or Multistate License?”
4. “Have you gained experience with Medicare or Medicaid?
Role: Clinical – Care Manager/Case Manager
Location: Remote Role/Home Based
Duration: 3+ Months Assignment
100% Remote Role – Seeking candidates across the United States for various positions accommodating different time zones
Day to day responsibilities of this the role (Outside of Workday JD):
• Remote Case management, Care manager (CM) follows model of care to assist member in managing health care needs.
• Conducts initial assessments, medication review, develops care plan with member, identifies member needs and connects member with appropriate resources to meet health care needs.
• Interacts with members care team, community services, vendors.
• Follows up with member every 30 days at minimum to review conditions, progress toward goals, and ensure member is receiving requested information and/or services.
• Provides education on member health plan and coverage and management of identified health conditions.
• Must have strong computer skills
• Excellent time management skills.
• Navigating multiple systems
Position Purpose:
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care
• Develop, assess and adjust, as necessary, the care plan and promote desired outcome
• Assess the member’s current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
• Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member’s needs
• Provide patient and provider education
• Facilitate member access to community based services
• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
• Actively participate in integrated team care management rounds
• Identify related risk management quality concerns and report these scenarios to the appropriate resources
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
Education/Experience:
• Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
• 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting.
• Knowledge of healthcare and managed care preferred.
• Knowledge of healthcare and managed care preferred.
• Prior experience working in a remote role preferred.
• Prior case management experience preferred.
Licenses/Certifications: Current state’s RN license.
EEO: “Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”
