Case Manager
The Judge Group Inc.

Dayton, Ohio

Posted in IT


Job Info


Location: Dayton, OH
Description:
Judge Healthcare is looking of a Case Manger in OH!

Must live in: Hamilton, Clermont, Butler, Warren, Clinton, Montgomery, Greene or Clark County.

Hours: Mon-Fri, 8a-5p EST

The Judge Group is looking for a Case Manager to be responsible for health care management and coordination for members to achieve clinical, financial, and quality of life outcomes.

**Must be willing to follow vaccine mandate and visit members in homes/hospital/nursing facility**

Essential Functions:

  • Conduct face to face or home visits as required.
  • Provide case management services to members with chronic or complex conditions including:
  • Identifies members that may qualify for potential case management services.
  • Conduct assessment of member needs by collecting in-depth information from our information system, the member, member's family/caregiver, hospital staff, physicians, and other providers.
  • Develop and implement a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.
  • Perform ongoing monitoring of the plan of care to evaluate effectiveness.
  • Measure the effectiveness of interventions to determine case management outcomes.
  • Promote integration of services for members including behavioral health and long-term care to enhance the continuity of care.

Knowledge/Skills/Abilities:

  • Knowledge of applicable state, and federal regulations.
  • Knowledge of ICD-9, CPT coding and HCPC.
  • SSI, Coordination of benefits, and Third-Party Liability programs and integration.
  • Familiarity with NCQA standards, state/federal regulations, and measurement techniques.
  • In depth knowledge of CCA and/or other Case Management tools.
  • Computer skills and experience with Microsoft Office Products.

Required:

  • Bachelor's degree in Nursing or master's degree in social work, or Health Education (a combination of experience and education will be considered in lieu of degree).
  • 0-2 years of clinical experience with case management experience.
  • Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing.
  • A combination of experience and education will be considered in lieu of LCSW or APSW.
  • Valid driver's license with good driving record and be able to drive locally.
If this sounds like an opportunity you would be interested in, please send your updated resume to chead@judge.com
Contact: chead@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com



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