- Strong organizational, supervisory and interpersonal skills
- Excellent written and verbal communication skills
- Ability to facilitate multi-disciplinary groups
- Detail oriented and high organized
- Excellent time management skills including the ability to multi-task and follow through on assignments.
- Demonstrated knowledge of care management, disease management and utilization management principles
- Demonstrated knowledge of Patient-Centered Medical Home principles.
- A minimum of five (5) years of clinical nursing experience is required
- A minimum of five (5) years of management experience in a managed care environment
- Experience in utilization management required, disease management experience preferred
- Demonstrated knowledge of utilization management principles
- Demonstrated knowledge of care management principles, including disease management
Education and/or Experience:
A Bachelor’s degree or equivalent experience, in a health related field is preferred.
Certificates, Licenses, Registrations:
- Certified Case Management (CCM) is preferred or other certifications recognized by URAC
- Current Registered Nurse license in the state of Florida and other states as required
Proficiency using software programs such as MS Word, ACCESS, PowerPoint, Excel and Outlook
Environmental Factors/Physical Demands:
Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and vision to monitor. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.
Registered Nurse - RN Clinical Services Manager- Managed Care - Clearwater, FL