Job Title: Care Manager II (RN)

Location: Indianapolis, IN 46204 (Remote)

Indiana Remote workers, may have occasional requirement to come into the office for staff meetings quarterly

Duration: Temp to Perm

Start date: 4/15/2024.

Pay-Rate: $50/Hr. on W2

Day shift: 8:00am – 5:00 pm EST, No weekends. May convert to alternate shift after 120 days/satisfactory completion of role orientation.

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.

Education/Experience:

Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.

Licenses/Certifications: Current states RN license.

Texas Requirements:

Education/Experience: Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2 years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2 years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.

Licenses/Certifications: Current states RN license.

For New Hampshire Healthy Families: Candidates with active RN license in good standing in other states than NH, must obtain the NH RN equi within 90 days of hire. Active drivers license in good standing preferred. CCM preferred.

• For Arizona Complete Health - Complete Care plan:
• Pediatrics assignments require 2 years RN experience in pediatrics (clinical acute care, community or managed care setting) and 1 year experience in care management
• Obstetrics (OB) assignments require 2 years RN experience in OB (clinical, acute, community or managed care setting) and 1 year experience in care management
• Licenses/Certifications: Current states RN license.

For Buckeye Community Health Plan:

• Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in nursing preferred. 2 years of clinical nursing experience in a clinical, acute care, or community setting and 1 years of case management or utilization experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care.
• Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.
• Licenses/Certifications: Current states RN license.

For Michigan Complete Health: Licensed registered nurse; licensed nurse practitioner; licensed physician's assistant. Valid driver's license required.

• 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.
• Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes.
• 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.
• 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.
• Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience.
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
• Direct care to participating network providers.
• Perform duties independently, demonstrating advanced understanding of complex care management principles.
• Participate in case management committees and work on special projects related to case management as needed.
• For New Hampshire, Massachusetts, & Michigan Complete Health - home visits required.

Job Type: Contract

Pay: $50.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Remote

Application Question(s):

• Your email address, contact number, and the best time to reach you?

Education:

• Bachelor's (Preferred)

Experience:

• Clinical Nursing: 5 years (Preferred)
• Case management or Utilization: 5 years (Preferred)
• Pediatric/ NICU: 5 years (Preferred)

License/Certification:

• RN License (Preferred)

Work Location: Remote