Care Manager I (RN) (In office position located in Philadelphia, PA)

Philadelphia, PA

Posted: 02/08/2019 Job Number: 24996
Description:
  • Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
  • Develop, assess and adjust, as necessary, the care plan and promote desired outcome Assess the member' s current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options.
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients.
  • Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member' s needs.
  • Provide patient and provider education Facilitate member access to community based services.
  • Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan.
  • Actively participate in integrated team care management rounds Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
  • For New Hampshire and Massachusetts - home visits required.
  • This position will be an in office position in either Harrisburg or Pittsburgh PA from 8-5, M-F.
Qualifications:
  • Graduate from an Accredited School of Nursing.
  • Bachelor’ s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting.
  • Knowledge of healthcare and managed care preferred.
  • Licenses/Certifications: Current state’ s RN license.
  • Valid driver’ s license and proof of car insurance.
  • Licenses/Certifications: Current state’ s RN license.
For more information on this position, please contact our office at 877-782-3334.
 

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