Certified Woman & Minority Owned

Nurse Case Manager


Reference Number: KBRINC6

Nurse Case Manager
experience  Not Disclosed
location  Woonsocket, RI (100% Remote)
duration  12 Months
salary  Not Disclosed
jobtype  Not Disclosed
Industry  Pharmaceutical
duration  $-4/hour - $1/hour
Job Description

Fully remote

Description:

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 with unrestricted active license in Florida.

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 member's 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.

Duties

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
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 hand written and computer generated documents as well as a PC monitor.
Typical office working environment with productivity and quality expectations

Experience
2-3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
2 years Healthcare and/or managed care industry experience.


Requires an RN with unrestricted active license in Florida.

Education
RN with current unrestricted state licensure.

Case Management experience required
Case Management Certification preferred.

Notes:
Monday-Friday, 8am-5pm EST, training hours the same
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

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