Reference Code: 7108
Position: Case Manager
Location: Franklin County area
Duration: 4-month Contract
Pay Rate: $34.50/hr
Our client, a Fortune 500 multi-state healthcare organization, is looking to hire a Case Manager who will be responsible for responsible for health care management and coordination of client?s members in order to achieve optimal clinical, financial and quality of life outcomes. The Case Manager is to work with members to create and implement an integrated collaborative plan of care. Coordinates and monitors client?s member?s progress and services to ensure consistent cost-effective care that complies with client?s policy and all state and federal regulations and guidelines. The Case Manager will do Case Management, Assessment and member calls and is expected to work Monday ? Friday 8:00 AM – 5:00 pm EST.
The Case Manager?s essential functions are as follows:
- Provides case management services to members with chronic or complex conditions including:
- Proactively identifies members that may qualify for potential case management services.
- Conducts assessment of member needs by collecting in-depth information from client?s information system, the member, member?s family/caregiver, hospital staff, physicians, and other providers.
- Identifies, assesses, and manages members per established criteria.
- Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.
- Performs ongoing monitoring of the plan of care to evaluate effectiveness.
- Documents care plan progress in client?s information system.
- Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes.
- Measures the effectiveness of interventions to determine case management outcomes.
- Promotes integration of services for members including behavioral health and long-term care to enhance the continuity of care for client?s members.
- Conducts face to face or home visits as required.
- Maintains department productivity and quality measures.
- Manages and completes assigned work plan objectives and projects in a timely manner.
- Demonstrates dependability and reliability.
- Maintains effective team member relations.
- Adheres to all documentation guidelines.
- Attends regular staff meetings.
- Participates in Interdisciplinary Care Team (ICT) meetings.
- Assists orientation and mentoring of new team members as appropriate.
- Maintains professional relationships with provider community and internal and external customers.
- Conducts self in a professional manner at all times.
- Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct.
- Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.
- Complies with required workplace safety standards.
- The Case Manager must have an active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing. A combination of experience and education will be considered in lieu of LCSW or APSW.
- The Case Manager must have a Bachelor?s degree in Nursing or Master?s degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree).
- The Case Manager must have 0-2 years of clinical experience with case management experience.
- The Case Manager must have valid driver?s license with good driving record and be able to drive locally.
- The Case Manager must be local to Columbus, OH
- The Case Manager must have Case Management, Assessment, and member calls experience
- The Case Manager must have demonstrated ability to communicate, problem solve, and work effectively with people.
- The Case Manager must have excellent organizational skill with the ability to manage multiple priorities.
- The Case Manager must have the ability to work independently and handle multiple projects simultaneously.
- The Case Manager must have strong analytical skills.
- The Case Manager must have knowledge of applicable state, and federal regulations.
- The Case Manager must have knowledge of ICD-9, CPT coding and HCPC.
- The Case Manager must have knowledge of SSI, Coordination of benefits, and Third-Party Liability programs and integration.
- The Case Manager must have familiarity with NCQA standards, state/federal regulations, and measurement techniques.
- The Case Manager must have in depth knowledge of CCA and/or other Case Management tools.
- The Case Manager must have the ability to take initiative and see tasks to completion.
- The Case Manager must have computer skills and experience with Microsoft Office Products.
- The Case Manager must have excellent verbal and written communication skills.
- The Case Manager must have the ability to abide by client?s policies.
- The Case Manager must be able to maintain regular attendance based upon agreed schedule.
- The Case Manager must be able to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- The Case Manager must be skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers, and customers.
For more information on the Case Manager, please call our Recruiter directly at (847) 278-8615. To submit your application, click on the 'Apply for Job' link below or send your resume directly to Rod.Ira@bluestonestaffing.com.
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