RN Manager, Case Management

Daily Responsibilities:

  • Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions
  • Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes
  • Promote compliance with federal and state regulations and contractual agreements
  • Develop, implement and maintain compliance with policies and procedures regarding medical case management
  • Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure
  • Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries


Requirements:

  • RN license
  • BS or equivalent experience
  • 5-7 years as an RN
  • 3-5 years as a manager/supervisor
  • Need some case management experience
  • Thorough knowledge of Medicare/Medicaid
  • Experience working with special needs patients (Aged, Blind, Disabled)
  • Experience doing assessments (health risk assessments) and developing care plans; need to be able to mentor staff on these items
  • Good computer skills are a MUST, especially with electronic clinical documentation systems, Excel, PowerPoint, Outlook

Hours for this Position:

Monday to Friday 8:00AM- 5:00PM

Advantages of this Opportunity:

Competitive Salary ranges $80,000 - $105,000 with 10% annual bonus opportunity. Benefits include Medical, Dental, Vision, 401K, and PTO

Interested in being considered?

If you are interested in being considered for the position, please contact Ashley Greene at 407-478-0332 ext 169.

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