Fully remote (never coming onsite)Description:Position Summary: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.Duties: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/servicesApplication and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriateadministration of benefitsUtilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and proceduresExperienceyears Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.Healthcare and/or managed care industry experience.Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentSedentary 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 hand written and computer generated documents as well as a PC monitor.Typical office working environment with productivity and quality expectations?Requires an RN with unrestricted active licenseEducationRN with current unrestricted state licensure.Case Management Certification CCM preferredNotes:Mon-Fri 8a-5p (EST)Fully remote (never coming onsite) VIVA 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
Description:Position Summary: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.Duties: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/servicesApplication and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriateadministration of benefitsUtilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and proceduresExperienceyears Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.Healthcare and/or managed care industry experience.Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentSedentary 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 hand written and computer generated documents as well as a PC monitor.Typical office working environment with productivity and quality expectations?Requires an RN with unrestricted active licenseEducationRN with current unrestricted state licensure.Case Management Certification CCM preferredNotes:Mon-Fri 8a-5p (EST)Fully remote (never coming onsite)
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