Registered Nurse Case Manager

Job Title:

Nurse Case Manager Job Location:

Must Reside in the

Martinsville, Roanoke, Lynchburg, Danville Schedule :

Monday - Friday 8:00 am - 5:00 pm

EST Pay Rate:

$ 44/ W-2 About Company Founded in 1996, CTC began as an IT organization and has evolved over nearly 30 years into a multidisciplinary solutions partner. CTC took our expertise to the next level by adding healthcare staffing and technology, forming CTC Medisource. CTC Medisource is a reliable partner that assists healthcare organizations in sourcing quality talent to improve the patient experience, scale the workforce, and increase operational performance. Headquartered in Detroit, Michigan, with a global team of more than 2,000 professionals, we bring deep expertise across Healthcare Staffing, AI & ML, Enterprise Applications, Digital Health, Managed Services, and Business Services.

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

Duties Assessment of Members:

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.

Enhancement of Medical Appropriateness and Quality of Care:

Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes Experience Experience 3 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. Experience preferred managing chronic conditions, such as diabetes, hypertension, and asthma.-Healthcare and/or managed care industry experience required. Case Management experience preferred.

Experienced Case Manager with a strong clinical background utilizing a collaborative, member-centered approach to assess, plan, and coordinate care 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. Proficient in Microsoft Office Suite with high utilization of Microsoft Excel, Outlook, and Teams. Previous LOCERI experience a plus. Skilled in conducting comprehensive assessments, interpreting clinical and benefits criteria, and developing individualized care plans that promote optimal, cost-effective health outcomes. Demonstrates expertise in managing complex and chronic conditions, applying clinical judgment to identify risk factors, address barriers to care, and support appropriate utilization of services.

Education :

RN in VA with current unrestricted state licensure or compact license.

Case Management Cert...ification CCM preferred This job can be searched asRN Case Manager ,Clinical Case Manager (RN) , Nurse Case Manager, Healthcare Case Manager ,

Case Management Nurse Pay:

$43.00 - $44.00 per hour

Benefits:

Dental insurance Vision insurance

Experience:

NURSE CASE MANAGER

4 years (Required)

LOCERI:

1 year (Required)

License/Certification:

RN (Required)

Work Location:

In person