Pediatric RN Case Manager - Hybrid

HIRING: Pediatric RN Case Manager – Hybrid in Pinellas Counties

HealthCare Support is actively seeking a Pediatric RN Case Manager to fill an opening with a largest Medicaid health plan and the largest not-for-profit Medicare-Medicaid plan in the country

Daily Responsibilities for Pediatric RN Case Manager:

• Will have a max of 40 members that are in Tiers 1 & 2 as they are medically fragile and will either live in nursing homes or have a nurse who helps care for them
• Making calls to parents of members to collect annual assessments, monthly required update call, a monthly face-to-face visit and if visit declined a second monthly call or a virtual visit replaces it. Calling DME companies and providers if a parent states a problem. Managing difficult parents at times, good communication skills. EXCELLENT documentation
• Complete all required calls/contacts/visits or calls in place of visits, collect assessments on time, compile monthly information regarding member status into an assessment called an ECC note that is required by end of month. Zoom calls or a phone call with the PDN agency every 6 months to review the care plan agency has provided. Great documentation needed, education provided
• Assessments are Needs Based - not clinical and not diagnosing the members/providing treatments. EX: linking to providers, referrals for equipment, community recourses, groceries, tutoring
• 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. 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.
• NCQA oversees the assessments they complete and have specific requirements on the depth of information that needs to be included in the requirements to meet NCQA standards. We provide resources to assist in documentation expectations. If the candidate is a good documenter then this is easily achievable
• The average length of the assessment varies, could be 5 minutes to an hour. Could be over an hour for assessments if parent is very talkative or needs in depth teaching due to being new to the health plan. Another parent may decline visits and wants the bimonthly phone calls to be five minutes or less. To keep it simple, this varies, and depends on the need of the member and /or what the parent desires.
  
  
  

Required Qualifications for Pediatric RN Case Manager:

• Clear and active FL RN License
• 2 years of pediatric nursing experience in a clinical setting as an RN
• 1 years of case management experience - Highly preferred
• Must have a Valid and Active Driver’s license, reliable transportation and insurance
• Excellent documentation experience
• Knowledge of MCO
• Must have MS Office exp - excel, outlook, word
  
  
  

Benefits for Pediatric RN Case Manager:

• Immediate enrollment in Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (Advocacy) Program
  
  
  

Other Details:

• Length of Assignment: 3 months with potential to extend before conversion to permanent
• Pay Details: $34-$44.50 /hr (weekly pay)
• Shift: Mon- Fri 8am- 5pm, 1 hour lunch
• Location: Pinellas Counties - 50% remote & 50% member facing
  
  
  

Interested in being considered?

If you are interested in applying to this position, please click Apply Now for immediate consideration.

For additional consideration, please email a copy of your resume to Joey.Carulla@healthcaresupport.com with your phone number, the job title and location, and our recruiters will reach out.

Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

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