Pediatric Registered Nurse Case Manager

An RN Case Manager is needed for a major managed care company in Connecticut!

Location: This is a 100% remote position, but need to be located in the state of Connecticut to be considered and have an active Connecticut compact RN license to be considered

Hours: M-F 8 AM - 5 PM

Description - External

  • 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

Responsibilities:

  • 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


Job Requirements:

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.
  • 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

*Work-from-home case management role


Interested? Apply today for immediate consideration!

Posted
09/11/2021
Type
Full time
Location
Hamden, CT 06517, US