Nurse Case Mgr I
The Judge Group Inc.

Miami, Florida

Posted in IT


Job Info


Location: REMOTE
Description: Hey there!

One of our biggest clients is currently seeking a FULLY REMOTE Nurse Case Manager!

This position is fully remote, working a Mon-Fri 8am-5pm schedule hiring ASAP!

In this position, you will be performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. You will be performing these duties telephonically or on-site such as at hospitals for discharge planning.

This job will have the following responsibilities:

  • Ensures member access to services appropriate to their health needs.
  • Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
  • Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
  • Coordinates internal and external resources to meet identified needs.
  • Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
  • Negotiates rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues.
Qualifications & Requirements:
  • Requires a BA/BS in a health related field
  • Must have GA or COMPACT RN license
  • Can sit anywhere, but WILL MAKE OCCASIONAL TRAVEL TO ATLANTA
  • At least 2+ years experience in Pediatrics ER
  • Prior case management experience needed

Now that you've spent the last few minutes reading this, send your resume to croche01@judge.com for immediate consideration!

I look forward to connecting with you!

Contact: croche01@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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