Position Purpose:

The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes

• Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
• Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or members needs to ensure appropriate administration of benefits.
• Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Required Skills & Education:

• 2 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
• 1 year of case management experience
• RN with current unrestricted state licensure.
• Case Management Certification-CCM -preferred

#INDAS

Job Type: Full-time

Pay: $44.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Education:

• Associate (Required)

Experience:

• case management: 1 year (Required)

License/Certification:

• Registered Nurse (Michigan State) (Required)

Willingness to travel:

• 75% (Required)

Work Location: On the road