Care Manager I (RN)

Spectraforce Technologies

United States, Florida, Jacksonville

13141 City Station Drive (Show on map)

May 03, 2024

Care Manager I (RN)

03 months

Compact License

Remote 100%

Licenses/Certifications:

Current state's RN license.

Remote, compact state needed with NY licensure.

Position Purpose:

Perform care management duties to assess, plan, and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost-effective care

* Develop, assess, and adjust, as necessary, the care plan and promote the desired outcome

* Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long-term goals, treatment and provider options

* Coordinate services between Primary Care Physicians (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients

* Develop a plan of care based upon assessment with specific objectives, goals, and interventions designed to meet member's needs

* Provide patient and provider education

* Facilitate member access to community-based services

* Monitor referrals made to community-based organizations, medical care, and other services to support the members' overall care management plan

* Actively participate in integrated team care management rounds

* Identify related risk management quality concerns and report these scenarios to the appropriate resources

* Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems

Education/Experience:

Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred.
2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.
Knowledge of healthcare and managed care preferred. Prior experience working in a remote role is preferred.
Prior case management experience is preferred. Bilingual in Spanish and English is preferred.

Licenses/Certifications:

Current state's RN license.

Remote, compact state needed with NY licensure.

Required Skills/Experience:		Preferred Skills/ Experience:
1.	Registered Nurse, 5 plus years of clinical RN experience	1.	Medicare Case management experience
2.	Compact License	2.	CCM certification preferred

*Pediatrics - birth to 21

*Work-from-home case management role