Registered Nurse - Case Manager

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Company: TotalMed

Location: Cincinnati, OH 45238

Description:

Registered Nurse-Case Manager

Job ID #1757996

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About this Role

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.

Job details

$43.13 / hour

Cincinnati Area, Ohio

Profession: Registered Nurse

Facility Type: ???

Specialty: Case Manager

Division: MedFi

Start Date: 02/24/2025

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Responsibilities

conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs

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

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 Qualifications

RN with current unrestricted state licensure

3+ years of clinical practice experience (hospital setting OR home health/ambulatory care)

Case management experience/ field work experience

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