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Nurse Case Manager

A Line Staffing Solutions

This is a Contract position in Del Mar, CA posted October 9, 2021.

LTSS Care Specialist openings with a major health insurance / managed care company based in the 32503 area Starting ASAP Apply now with Jake Z.

at A-Line Position will be remote but will eventually require local travel
– Candidate must reside either in th e Pensacola FL 32503 area Job Summary: Managing a case load for healthcare members with long term care needs.

Monthly and quarterly member contact and will include 80% travel.

Remote role.

Will require a drivers license.

Member assessments and notes.

Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development Pay Rate: $20-25 hourly (determined on experience) Work Schedule: Monday
– Friday 8am – 5pm Job duties: Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact Authorize and coordinate referral for services Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care Assist in coordinating the development of informal or voluntary services to integrate into the member care plan Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care Assist member with filing and resolving complaints and appeals.

Required Experience: Bachelor’s degree in human services related field; Including but not limited to (Child, Family and Community Services, Early Childhood Development, Guidance and Counseling, Home Economics, Human Development Counseling, Human Services Administration, Human Services, Health Administration, Master of Divinity, Pastoral Care/Counseling, Psychiatry, Nursing, Psychology, Public Admin, Social Science, Social Work, Sociology) 2 years of Care Management experience Experience with electronic medical health records, and Microsoft office programs Preferred Skills/ Experience: Current Illinois RN, LCSW, LCPC, LSW, LPC licensure LTSS/HCBS waiver experience Care Coordination experience Home visit experience Remote/Work from home experience Plan of Care experience Why Apply: Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability 401k after 1 year of employment: With employer match and profit sharing GREAT Hours Monday through Friday, 40 hours per week Competitive Pay Rate Keywords: Long Term Support Services, LTSS, LCSW, LCPC, LSW, LPC, Concurrent Review, Retrospective Review, CCM, InterQual, ICD-10, URAC, CMS, Medicare, Medicaid, Case Management, Certified Case Manager, Medical Coding, BSN, Medical Management, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, HMO, Concurrent Review, Retrospective Review, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls.