50% Field and 50% Remote Opening as a Nurse Case Manager II - (Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties ): MI

Remote Full-time
Job Description: Job ID: 25-337342 Job Title: Nurse Case Manager II Estimated Length of Assignment: 03+ Months with Possible Extension (The dates provided are only an estimate and not a guarantee) Negotiable Estd. Pay Range - $40.00/Hour to $45.00/Hour on W2 (USD) –All Inclusive Work Type: Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties ): MI Schedule –Monday-Friday 8am-5pm EST Description: Field and Telephonic Add city/state, zip and county at the top of the resume Candidates should be either in one of these counties or very close to it. They will be traveling to this region. Sourcing for Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties ): MI. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures Experience 3 years Clinical practice experience, e.G., hospital setting, alternative care setting such as home health or ambulatory care required. Healthcare and/or managed care industry experience. Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Typical office working environment with productivity and quality expectations? Position Summary The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license for MI. Education RN with current unrestricted state licensure for MI. Case Management Certification CCM preferred What days & hours will the person work in this position? List training hours, if different. Monday-Friday 8am-5pm EST Remote About the Company: Lancesoft Apply tot his job
Apply Now →

Similar Jobs

Media Sales Director - CDO Magazine

Remote Full-time

Chief Financial Officer (Remote) at FinStrat Management

Remote Full-time

VP, Business Information Security Officer

Remote Full-time

Vice President of Engineering, Chief Information Security Officer (CISO)

Remote Full-time

[Remote] Chief Compliance Officer, Derivatives Exchange

Remote Full-time

Senior Organizational Change Manager (OCM) - Client Engagement

Remote Full-time

Change Consultant

Remote Full-time

VA for Chat Support

Remote Full-time

Experienced Remote Live Chat Support Specialist – Flexible Part-Time Opportunities for Customer Service Enthusiasts, $25-$35/HR

Remote Full-time

Chat Support Specialist

Remote Full-time

Senior Salesforce Developer II

Remote Full-time

**Experienced Full-Time Remote Customer Service Representative – Emergency Roadside Service Specialist at arenaflex**

Remote Full-time

Accountant Full-Time / Part-Time ( Day and Night Shift).

Remote Full-time

Sr. Mergers & Acquisitions (M&A) Consultant

Remote Full-time

Entry Level Writing Jobs Remote - No Degree Necessary

Remote Full-time

**Experienced Entry-Level Data Entry Specialist – Virtual From Home Opportunity at blithequark**

Remote Full-time

Experienced Full Stack Senior Data Engineer – Cloud, Big Data, and Analytics Solutions at Blithequark

Remote Full-time

Freelance Online Researcher – Academic Projects

Remote Full-time

[Remote] Customer Service Representative - Bilingual Required

Remote Full-time

Amazon Work From Home Part Time Job – USA Remote Jobs

Remote Full-time
← Back to Home