Nurse Case Manager II - Central OH

Job ID: 25-295259

Position Type: Full time

Location: Franklin, Union, Delaware, Pickaway, and Madison Counties for in-person visits with 75% travel.

Work Type: Field

Est. Pay Range: $35.95/hr. To $39.41/hr.

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.

Duties:

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

Required Qualifications:

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.

Education:

RN with current unrestricted state licensure.

Case Management Certification CCM preferred

Employee Benefits:

At LanceSoft, full time regular employees who work a minimum of 30 hours a week or more are entitled to the following benefits:

Four options of medical Insurance

Dental and Vision Insurance

401k Contributions

Critical Illness Insurance

Voluntary Permanent Life Insurance

Accident Insurance

Other Employee Perks

LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws.

This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.