Remote Nurse Care Manager
Job #:
20-02365
Position Type:
Contract
Location:
Dover, DE
Onsite Flexibility:
All Onsite
Job Description
789-1 Remote Nurse Care Manager, Wilmington, DE area 3 months contract
Sigma Inc is currently looking for a Nurse to work as a Care Manager toMaintain oversight over specified panel of members by performing ongoing assessment of members’ health management needs, identifying the right clinical interventions to address member needs and/or triaging members to appropriate resources for additional support.
Responsibilities
Maintain oversight over specified panel of members by performing ongoing assessment of members’ health management needs, identifying the right clinical interventions to address member needs and/or triaging members to appropriate resources for additional support.
For assigned case load, create care plans to address members’ identified needs, remove barriers to care, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals and plan of regular contacts for re-assessment.
Ensure targeted percentage of patient goal achievement (i.e., realization of member care plan), and other patient outcomes, as applicable, are achieved.
Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements and accreditation standards.
Maintain current knowledge and adheres to applicable CMS, state, local, and regulatory agency requirements and applicable standards of practice for case management including those published by CMSA and/or ACMA, as required by the organization.
Other duties as assigned or requested.
Requirements
Educational requirements: High School Diploma/GED
Professional experience, skills and qualifications:
7 years of any combination of clinical, case management and/or disease/condition management experience, provider operations and / or health insurance experience
RN license in DE.
Written and verbal presentation skills, negotiation skills, and skills in positively influencing others with respect and compassion
Broad knowledge of disease processes
Understanding of healthcare costs and the broader healthcare service delivery system
Proficiency in MS Excel and computer skills.
Strong analytic skills with ability to interpret, evaluate and act on clinical and financial data, including analysis of statistical data
Excellent interpersonal/ consensus building skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization
Ability to work in a high performing team environment that requires flexibility
Demonstrated ability to handle multiple priorities in a fast paced environment. Excellent organizational, time management, problem solving, and project management skills
Self-directed; self-starter, ability to work successfully with indirect supervision and moderate autonomy
Must be based in the New Castle County area
Preferred Qualifications:
Educational requirements: Bachelor’s Degree in Nursing
Professional experience, skills and qualifications:
Advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing or dialectical behavior therapy (DBT)
Experience working with the healthcare needs of diverse populations
Understanding of the importance of cultural competency in addressing targeted populations
Experience working at either Quantum or Accolade
Certification in Case Management
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