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Case Manager

Durham, North Carolina

100% Remote

Contract

$34/hr - $36/hr

Our client, a nationally recognized and award-winning company in the health insurance vertical, has a contract opening for a Case Manager. They have over 4 million customers and 5,000+ employees dedicated to providing innovative solutions that simplify the healthcare system, improve efficiency and outcomes while reducing costs.

**Location:** ** While the position is Remote, work from home, you must reside in North Carolina or one of the following states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

Contract Duration: 5+ Months

Required Skills & Experience

+ For Behavioral Health specific roles, other applicable licensure may be considered with a minimum of 3 years of clinical experience.

+ Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties.

+ CM Experience

+ Wide spread nursing experience(not being stuck in just one silo of nursing

+ Non compact licensure

Desired Skills & Experience

+ Telephonic experience

+ shown experience with time management

+ comfortable working in different systems

What You Will Be Doing

Daily Responsibilities

• Serve as a team member on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes.

• Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning.

• Develop a member-centric plan tailored to members’ needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care

• Utilize community resources and funding sources as needed in the development of the plan of care.

• Perform ongoing monitoring and management of member which may include scheduled follow-up with member, discussion of plan with member, appropriate services/education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plan/goals as needed, with contact frequency appropriate to member acuity.

• Evaluate and facilitate care provided to members through the continuum of care (physician office, hospital, rehabilitation unit, skilled nursing facility, home care, etc).

• Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes

• Effectively document all aspects of the plan from the initial assessment, development of the plan, implementation, monitoring, and evaluating outcome.

• May outreach directly to members identified as high risk, high cost, or high utilization cases.

• May review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options, where eligible.

• May evaluate medical necessity and appropriateness of services as defined by department.

• As needed, develop relevant policies/procedures, education or training for use both internally and externally.

****To be eligible to contract at this client you must be able to pass a drug test and criminal background check

You will receive the following benefits:

+ Medical Insurance - Four medical plans to choose from for you and your family

+ Dental & Orthodontia Benefits

+ Vision Benefits

+ Health Savings Account (HSA)

+ Health and Dependent Care Flexible Spending Accounts

+ Voluntary Life Insurance, Long-Term & Short-Term Disability Insurance

+ Hospital Indemnity Insurance

+ 401(k) including match with pre and post-tax options

+ Paid Sick Time Leave

+ Legal and Identity Protection Plans

+ Pre-tax Commuter Benefit

+ 529 College Saver Plan

Motion Recruitment Partners (MRP) is an Equal Opportunity Employer. All applicants must be currently authorized to work on a full-time basis in the country for which they are applying, and no sponsorship is currently available. Employment is subject to the successful completion of a pre-employment screening. Accommodation will be provided in all parts of the hiring process as required under MRP’s Employment Accommodation policy. Applicants need to make their needs known in advance.

**Posted by:** Andrew Chadwick

Specialization:

+ Medical / Healthcare Professional