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Nurse Case Manager - Direct Hire

Sacramento, CA | Direct Hire Position

Post Date: 07/10/2018 Job ID: 39698.1 Industry: Healthcare/Medical
We are currently recruiting for a Nurse Case Manager to be responsible and accountable for coordination of servicesfor clients referred for complex case management. The Nurse Case Manager follows and manages the course of treatment for patients while coordinating care with physicians, nurses, case managers and other staff from outside and within the client to ensure quality care and safe outcomes. This position will also conduct initial and ongoingassessments, incorporate disease management protocols, ensure continuity of care through discharge planning and utilization of resources, and shift cost to appropriate payers. Apply today!

Responsibilities: Proactively assesses potential cases and actively manages all high risk, high volume cases. Performs care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans. Researches and refers members to sources for alternative funding, community services and other services which may provide support to the patient and family. Identifies cases for possible peerreviewers to evaluate the appropriateness and necessity of care and or quality of care concerns. Assures referrals are complete and enrollment/eligibility benefits verified, prior to authorizing inpatient/outpatient care. May refer to social worker, or other services as needed. Completes appropriate, accurate and timely, documentation intoEMR system. Travel is required.

Requirements: 2 years professional nursing experience in an acute setting preferred or; 2 years' utilization/case management experience in the managed care industry. Medicaid experience a plus. Outstanding communication skills, both oral and written. Excellent active listening and criticalthinking skills. Strong multi-tasker who can exercise excellent time management and meet multiple deadlines. Ability to exercise sound discretion and strict confidentiality. Self-motivated with strong organizational and multi-tasking skills.

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