"Alerted.org

Timing: M-F 8-5

Job Description:

The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.

Responsibilities:

+ Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services

+ Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or members needs to ensure appropriate administration of benefits

+ Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Skills:

+ Utilization review

+ RN

+ Assure care

+ Clinical practice

+ Medcompass

Experience:

+ 3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.

+ Healthcare and/or managed care industry experience.

+ Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

+ Effective communication skills, both verbal and written.

+ Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

+ Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.

+ Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.

+ Typical office working environment with productivity and quality expectations.

Education:

RN with current unrestricted state licensure.

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity,