The Case Manager utilizes a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN, MSW, LLBSW, LLMSW, or LBSW with an unrestricted active licenseThrough the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines the 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 proceduresEducation RN with current unrestricted state licensure.Case Management Certification preferred** 2-3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.** 2-3 years Healthcare and/or managed care industry experience preferred.** ICU Nurse Preferred.** 2-3 years Case Management / Managed care / care planning experience preferred--** Position requires proficiency with computer skills which includes navigating multiple systems, apps, software, data mining and keyboarding** MS office suite especially Word and Excel a MUST Effective communication skills, both verbal and written.- Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment- Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone, and typing on the computer.- Work requires the ability to perform close inspection of computer-generated documents as well as a PC monitor.- Typical office working environment with productivity and quality expectations- Homecare experience is required,Verifyable High School Diploma or GED RequiredALERT: This employer requires all employees, temporary labor, consultants, and contractors to be fully vaccinated against COVID-19 by their start date (other date may be inserted if start date is not accurate), subject to approved medical or religious exemptions.Shift time :M-Fr 8a to 5p Remote with future possibility of onsiteVIVA is an equal opportunity employer. All qualified applicants have an equal opportunity for placement, and all employees have an equal opportunity to develop on the job. This means that VIVA will not discriminate against any employee or qualified applicant on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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