Care Manager I (RN) Spectraforce Technologies Job Title: Care Manager I
Job Location: Remote
Job Duration: 03 Months (With possible extension)
Description -
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 - External
Education/Experience :
Graduate from an Accredited School of Nursing.
Bachelor's degree in Nursing preferred. 2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.
Florida residency required. Knowledge of healthcare and managed care preferred. Prior experience working in a remote role preferred. Prior case management experience preferred. Bilingual in Spanish and English is preferred.
Licenses/Certifications : Current state's RN license.
*Pediatrics - birth to 21
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