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Nurse Case Manager

Employer
The CSI Companies
Location
Detroit, MI
Closing date
Jan 24, 2021

View more

Profession
Nurse
Specialty
Medical Management
The CSI Companies is actively seeking a Nurse Case Manager for our client located in the Michigan area.

We are looking for someone who is available to work the following hours:
  • Mon- Fri 8 hours a day

Details:

The Nurse Case Manager 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.

Duties:
  • Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility
  • 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 member'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
Requirements
  • Verifiable high school diploma or equivalent
  • RN with current unrestricted state licensure.
  • Case Management Certification (CCM) preferred
  • 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-- Position requires proficiency with computer skills which includes 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
  • Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
  • Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
  • Typical office working environment with productivity and quality expectations

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