Local Contract Nurse RN - Case Management
Detroit, MI
CTC Medisource
5x8 hrs

Location : Candidate MUST reside in one of these counties: Berrien, Van Buren, Cass, Kalamazoo, St. Joseph, Calhoun, Branch, Jackson, Hillsdale, Livingston, Washtenaw, Lenawee, Monroe, Oakland, Macomb, Wayne, Clinton, Eaton, or Ingham

Key Skills :
• Must have an active and unrestricted RN license in the state of Michigan.
• 3 years clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
• Candidates will need a quiet, dedicated work space with no distractions. This role will require that the candidate be hard wired into the modem. Candidates will need to secure a long enough ethernet cord at their own expense.
• Experience managing chronic conditions, such as diabetes, hypertension, and asthma.
• Experience preferred managing the CSHCS population (Children's Special Health Care Services)
• Healthcare and/or managed care industry experience required.
• Case Management experience required .

Schedule :Monday - Friday 8:00 am - 5:00 pm EST.

Duties
• 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 member's 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.