Job Description
About the Job:
- Strictly telephonic
- Working as a case/care manager for all ages from Peds to Geriatric, coordinating services and identifying barriers to care (Medicare & Medicaid members).
- Keeping patients on track with care plans and educate them about their conditions and treatments.
- Could be contacting providers (doctors) to clarify information/plans and then relaying that info back to the patient.
- Flagging any potential issues and teach patients how to know when they should get themselves to a hospital.
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 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 Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
- Develop 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
Qualifications
- RN license
- Several years of of clinical nursing experience in an acute care or other setting.
- Proficiency in Excel & other MS products, email, etc.
- Will not be writing things down in a chart and then inputting them later; they'll be talking on the phone with a patient or provider and data entering into the computer simultaneously. Don't need to be "experts," but need to be able to navigate around a computer while multitasking
- Soft skills: need to be okay with change and not need a lot of individual attention. Good conflict resolution and team work skills
Hours for this Position:
M-F 8-5
Advantages of this Opportunity:
- Competitive salary
- Fun and positive work environment
- Matching on 401K
- Ticket into Managed Care
Additional Information
Want More Information?
• If you are interested in applying to this position, please contact Ashley Greene at 407-478-0332 ext 169 or email and click the Green I’m Interested Button to email your resume.
Company Description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!