Care Manager II (RN)

Company: BCforward
Location: Indianapolis
Posted on: May 2, 2024

Job Description:

BCForward is currently looking for Care Manager II (RN) in Remote for IN. Job Title: Care Manager II (RN)Location: Indianapolis, IN 46204 (Remote)Duration: Temp to PermPay-Rate: $50/Hr. on W2Day shift: 8:00am - 5:00pm EST Mond through Friday. Position Purpose:Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care. Education/Experience:Graduate from an Accredited School of Nursing. Bachelor's degree in nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e., InterQual, NCCN) and government sponsored managed care programs. Licenses/Certifications: Current states RN license. Texas Requirements:Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care, or community setting. 2+ years' experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e., InterQual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply. Licenses/Certifications: Current states RN license. For New Hampshire Healthy Families: Candidates with active RN license in good standing in other states than NH, must obtain the NH RN equip within 90 days of hire. Active driver's license in good standing preferred. CCM preferred.

• For Arizona Complete Health - Complete Care plan:
• Pediatrics assignments require 2+ years RN experience in pediatrics (clinical acute care, community, or managed care setting) and 1+ year experience in care management.
• Obstetrics (OB) assignments require 2+ years RN experience in OB (clinical, acute, community or managed care setting) and 1+ year experience in care management.
• Licenses/Certifications: Current states RN license. For Buckeye Community Health Plan:

• Education/Experience: Graduate from an Accredited School of Nursing. Bachelor's degree in nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management or utilization experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care.
• Experience with medical decision support tools (i.e., InterQual, NCCN) and government sponsored managed care programs.
• Licenses/Certifications: Current states RN license. For Michigan Complete Health: Licensed registered nurse; licensed nurse practitioner; licensed physician's assistant. Valid driver's license required.
  • Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short- and long-term goals, treatment, and provider options.
  • Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes.
  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.
  • Provide patient and provider education.
  • Facilitate member access to community-based services.
  • Monitor referrals made to community-based organizations, medical care, and other services to support the members overall care management plan.
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience.
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
  • Direct care to participating network providers.
  • Perform duties independently, demonstrating advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed.
  • For New Hampshire, Massachusetts, & Michigan Complete Health - home visits required. Required:
  • Registered Nurse
  • Pediatric/ NICU Experience
  • Case Management 1+ years
  • Telephonic outreach experience
  • Medicaid experienceBenefits:BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k. About BCforward:Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.Interested candidates please send resume in Word format Please reference job code 221921 when responding to this ad.

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