Nurse Case Manager II - OHIO - Toledo Region

Job Title:

Nurse Case Manager II - OHIO - Toledo Region

Address:

Verify with a Recruiter or Staffing Manager!

Schedule:

Monday thru Friday, 8 am to 5 pm.

Job Description

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.

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 memberâ 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. Critical Information

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.

Computer skills, including 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. Education/Licenses Needed

RN with current unrestricted state licensure.

Case Management Certification CCM preferred. Benefits:

Benefits are available to full-time employees after 90 days of employment.

A 401(k) with company match is available to full-time employees after 1 year of service.

This is an AI-formatted job description; therefore, this does not remove human decision-making.