Case Manager

• RN Diploma, RN Associate’s degree or Bachelors of Science in Nursing (BSN) degree.

• Minimum of 3 years full time direct clinical experience in an acute medical or acute surgical setting.

• Proficiency with a Microsoft Windows operating system

• Must have valid license to practice nursing within the US and have started application for NC nursing license.

• May be required to work weekends and holidays on a rotational basis.

• Commercial Care Management: Certified Case Manager (CCM) certification is required within 2 years of employment.

• FEP and Senior Segment: Certified Case Manager (CCM) certification is required within 3 years of employment.

• Hiring Preferences: The incumbent must possess medical management/clinical decision-making skills and sound skills in assessing, planning and managing member care, Advanced assessment and teaching skills.

• Problem solving skills: Familiarity with legal terminology and liability issues and ability to handle ethical or risk management issues. Utilization and Quality Management/Outcomes experience preferred

• Previous work experience with a managed care organization or provider is also preferred.

• Prior experience in case management, home health, discharge planning, or Concurrent review.

• Excellent communication and interpersonal skills with all levels of internal and external customers necessary.

• Individual must be self-motivated/self-directed.

• Must possess the abilities to work independently, demonstrate effective time management skills, and to prioritize effectively.

• The ability to deal effectively with change within the unstructured nature of case management and remain focused.

• Demonstrates creativity, critical thinking, counseling, interviewing, negotiating, and research skills. Certified Case Manager (CCM) certification preferred.

• Senior Segment: Prior experience in a variety of health care settings is preferred. Certified Case Manager (CCM) preferred. Experience with managing and coordinating care for patients who have multiple co-morbidities is preferred. Experience in responding to the diverse needs of the Medicare population, which includes both over 65 and under 65 aged adults.

• Commercial Care Management: Multi-State Licensure preferred.

• Prior experience in a variety of health care settings is preferred.

• Experience with managing and coordinating care for patients who have multiple co-morbidities is preferred

• Training class is targeted for 10/31, all candidates will need to start the same day.

• Hours: 8am -5pm and 10am-7pm. with an hour lunch.

All your information will be kept confidential according to EEO guidelines.