Job Description :
Hi,
We’re hiring for our client for below position. Kindly take a look & let me know if you’re interested in applying for it. Feel free to revert/call if you have any query!
Position Case Management Senior
Job Title Nurse Case Manager Senior
Location Rancho Cordova, CA
Duration Temp-to-hire (3 months contract)
Work hours 8 hours/day | 40 hours/week
Interview mode Onsite
Day to Day Responsibilities of this Position and Description of Project:
Determines, develops and implements a plan of care based on accurate and comprehensive assessment of the member’s needs.
Applies detailed knowledge of FEP PPO and Blue Shield of California’s (BSC) established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case.
Works with complex cases, promotes the delivery of quality; cost-effective health care services based on medical necessity and contractual benefits.
Provides guidance to the provider network.
Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care.
Coordinates Care for Lower Level of Care coordination such as Skilled Nursing Facility, Home Health, Home Infusion, Rehab.
Makes referrals to Quality Management, Catastrophic Case Management and Appeals and Grievance Department.
Required Skills:
Registered Nurse
Strong Case Management/Disease Management Experience
Specialty Training in at least one area: Behavioral Health, Diabetes, Cardiac Conditions, or Respiratory Conditions
Strong Computer skills: PC-based software programs, Word, Excel, Outlook
Strong communication skills
Good to have:
Solid acute care background
Care Management experience (discharge planning, coordination of care or disease management education)
Telephonic experience
Evidence of Good Computer skills
Education Requirement:
Bachelors of Science in Nursing or advanced degree preferred
Software Skills Required:
PC-based software programs, Word, Excel, Outlook
Required Certifications:
Prefer CCMC (Commission for Case Manager Certification)