Description: Judge Healthcare is currently seeking an RN Care Manager for a top Managed Care company, 100% remote WORK FROM HOME (MUST be located in MST or PST time zones).
This position is servicing Tricare beneficiaries and is a great opportunity helping out veterans, current service members, and their families.
Responsibilities of this position include:
Provides case/care management services to Tricare beneficiaries and their families.
Screens cases for possible case management services according to predetermined criteria. Systematically identifies and addresses fragmentation of care, and fill gaps in care using proactive initiatives.
Authorizes inpatient and/or outpatient treatment according to company's stated criteria. Evaluates physician's treatment plan and other records to develop a care plan to assist patient to move as rapidly and cost effectively as possible through health care services.
Coordination of Care
Contacts members of the medical team to discuss the patient's course of progress and needs. Arranges for all services required and coordinates services with the health care team to eliminate duplication of services and conserve health benefit dollars.
Contacts family to ascertain their understanding of the patient's diagnosis and prognosis and the ability to provide caregiver support.
Qualifications & Requirements:
Graduate of Nursing program
Certified Case Manager (CCM) current and active required
Recent Managed Care Experience Required
3-5 years RN case management experience
Behavioral Health experience
Must be Covid vaccinated, no exceptions
Must reside in MST or PST
If you or anyone you know may be interested in this position, please send an updated resume to DFriedman@judge.com or give Dave a call at 770-696-8035 to inquire more.
This job and many more are available through The Judge Group. Find us on the web at www.judge.com