Case Managers/Utilization Review-Multiple Openings!

Company: The Palmer Group ( Learn More )

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General Information
US-IA-Des Moines
$53,000.00 - $55,000.00 /Year
Not Specified
Full-Time
At least 4 year(s)
Not Specified
False
False
Job Description Our Des Moines client is seeking multiple Case Managers/Utilization Review to join their team. Qualified RN's with clinical experience in either OBGYNs or Advanced Care please apply! The qualified candidates will proactively identify and provide telephonic complex care management interventions for members.

Duties Include

  • Completing assessments to identify barriers to care and gaps in health care, then creating and managing individual care plans that ensure members receive appropriate care and achieve health care goals.
  • Collaborate with members, members' families, health care providers and community resources to coordinate the care and services provided to members.
    • Job Requirements
    • Completion of an Accredited registered nursing program
    • 4-6 years clinical experience in an acute care or outpatient setting with a minimum of 4 years full time equivalent of direct clinical care to the consumer
    • Active and unrestricted RN license in Iowa or South Dakota (individual must be licensed in the state in which they reside)
    • Demonstrated verbal and written communication skills including success to influence others (without direct leadership) and negotiate care with members, physicians, care facilities or similar audiences
    • Experience effectively establishing relationships and engaging with patients or members through telephonic communication
    • Experience with computer software applications (e.g. electronic charting, Microsoft Suite, documentations systems, etc)
    • Knowledgeable of regulatory standards and regulations (e.g. URAC, NCQA, HIPAA, PHI, confidentiality)
    • Ability to travel as needed
    • Valid driver's license required
    Preferred Qualifications
    • Bachelors Degree in Nursing, Health Care Administration or Public Health
    • Certification as a Certified Case Manager (CCM) Must attain CCM within 24 months after hire, and maintain throughout employment.
    • Previous work experience in case management. Includes assessment of members, creating and managing care plans, etc.
    • Previous experience working independently and managing an assigned caseload in a metrics based environment
    • Demonstrated experience interpreting health care benefits

    Pay: $53,000-$55,000/year Hours: 8:00AM-5:00PM M-F

    If you are interested, please apply online at www.thepalmergroup.com. If you are already registered with Palmer Group, please send an updated resume to Orlando at [Click Here to Email Your Resumé].

    Apply Now