Remote Er Case Manager

Description

Responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. Primary duties may include, but are not limited to: - Ensures member access to services appropriate to their health needs.- Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.- Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.- Coordinates internal and external resources to meet identified needs.- Monitors and evaluates effectiveness of the care management plan and modifies as necessary.- Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. - Negotiates rates of reimbursement, as applicable. Assists in problem solving with providers, claims or service issues.

Skills

case management, ER, Emergency department, clinical care, care management, hospital setting, bedside

Top Skills Details

case management,ER,Emergency department,clinical care,care management

Additional Skills & Qualifications

Team: Medicaid Georgia MarketAsk: Seeking to bring on 5 temp contractors for nurse case management 2 temps will be for ERLooking for candidates with 2-5 years of ER experienceDISCOVERY CALL NOTES:Work From Home position. In person team meeting at times - will be given a heads up priorCan sit remotely, but must have a GA license. Must sit in Atlanta, GA if possible.At least 2 years of experience in ER, pediatric population preferredMost of the calls are outbound, assigned 2-5 cases today and live transfers for members who call inCaseloads are 60 plus for the ER case managersHave experience working from home and being on the phone all dayMonday through Friday 8-5 ESTHospital setting, ER, Critical care and bedside experience is nice to havePrior case management experience is neededVideo interviews, 1 hourNovice computer skillsMotivational Interviewing knowledgeAbility to toggle between multiple systems,

Experience Level

Entry Level

About Actalent

Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. Were supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.