Case Manager

Durham, NC

100% Remote

Contract

$30/hr - $39/hr

Our client, a nationally recognized and award-winning company in the health insurance vertical, has a contract opening for a Case Manager. They have over 4 million customers and 5,000+ employees dedicated to providing innovative solutions that simplify the healthcare system, improve efficiency and outcomes while reducing costs.

Location: ** While the position is Remote, work from home, you must reside in North Carolina or one of the following states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

Hours: One night a week hours will be 11 am to 7:30 pm. May need to work one saturday from 9 to 1 if needed

Contract Duration : 3+ Months

Required Skills & Experience

• Healthcare Experience

• RN with 3 years of clinical and/or case management experience required.

• Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties.

• CDCES required.

What You Will Be Doing

Daily Responsibilities

• Serve as Certified Diabetes Educator on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes.

• Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning.

• Develop a member-centric plan tailored to members’ needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care

• Utilize community resources and funding sources as needed in the development of the plan of care.

• Perform ongoing monitoring and management of member which may include scheduled follow-up with member, discussion of plan with member, appropriate services/education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plan/goals as needed, with contact frequency appropriate to member acuity.

• Evaluate and facilitate care provided to members through the continuum of care (physician office, hospital, rehabilitation unit, skilled nursing facility, home care, etc).

• Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes

• Effectively document all aspects of the plan from the initial assessment, development of the plan, implementation, monitoring, and evaluating outcome.

• May outreach directly to members identified as high risk, high cost, or high utilization cases.

• May review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options, where eligible.

• May evaluate medical necessity and appropriateness of services as defined by department.

• As needed, develop relevant policies/procedures, education or training for use both internally and externally.

*To be eligible to contract at this client you must be able to pass a drug test and criminal background check*

You will receive the following benefits:

• Medical Insurance - Four medical plans to choose from for you and your family

• Dental & Orthodontia Benefits

• Vision Benefits

• Health Savings Account (HSA)

• Health and Dependent Care Flexible Spending Accounts

• Voluntary Life Insurance, Long-Term & Short-Term Disability Insurance

• Hospital Indemnity Insurance

• 401(k) including match with pre and post-tax options

• Paid Sick Time Leave

• Legal and Identity Protection Plans

• Pre-tax Commuter Benefit

• 529 College Saver Plan

Motion Recruitment Partners is an Equal Opportunity Employer, including Veterans/Disability/Women. All applicants must be currently authorized to work on a full-time basis in the country for which they are applying, and no sponsorship is currently available. Accommodation will be provided in all parts of the hiring process as required under Motion Recruitment Employment Accommodation policy. Applicants need to make their needs known in advance.

Posted by: Andrew Chadwick

Specialization: Medical / Healthcare Professional