RN Case Manager
Columbus, OH

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RN High Risk

ASSOCIATE HIGH RISK RN CASE MANAGER
Job Summary: Use decision support software in order to perform telephonic clinical health information services for managed health plans and external clients. Coordinate the care, services and health benefits for selected member populations across the continuum of illness. Monitor and promote effect utilization of healthcare resources through clinical variance and benefits management.

Essential Functions:
Coordination of Member Care: Complete member assessments by gathering information from the member, family and treatment team; Develop care plan, defining specific issues, goals and interventions as agreed to by all parties; Assist in education of members regarding healthcare access and benefits, and provide members with health education and wellness materials; Verify eligibility, previous enrollment history, demographics and current health status of each member
Documentation: Maintain current and accurate documentation of telephonic contacts, treatment plans, case notes, referrals, and assessments in Case Management electronic record; Maintain appropriate documentation within protocols and guidelines of the Case Management program
Education/Training: Assist in education of member/caregiver regarding healthcare access and benefits, and provide member/caregiver with health education and wellness materials; Precept and/or mentor new staff
Perform any other job related instructions as requested, with reasonable accommodation.

Minimum Qualifications
Education: Associate Degree (instead of a Bachelors) in nursing is required

Certification/Licensure/Background Check :
Current, unrestricted RN licensure in Ohio
Employment in this position is conditional pending successful clearance of a driver’s license record check. If the driver’s license record results are unacceptable, the offer will be withdrawn or, if you have started employment in this position, your employment in this position will be terminated
Employment in this position is conditional pending successful clearance of a criminal background check. If the criminal background results are unacceptable, the offer will be withdrawn or, if you have started in this position, your employment in this position will be terminated

Experience:
Three or more years of clinical experience is preferred
Two years’ managed care/case management experience is preferred

Technical & Knowledge Skills:
Basic Computer Skills including MS Windows, Word and Excel skills –
Communication Skills
Ability to work independently and within a team environment
Familiarity of the healthcare field
Critical listening and thinking skills
Proper grammar usage
Time management skills
Proper phone etiquette
Customer service oriented

Miracle Workers - 20 months ago - save job