Travel Nurse RN - Case Manager - $40 to $45 per hour in Sterling, VA
Conflux Systems Inc
Sterling, VA
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JOB DETAILS
SALARY
$40–$45
SKILLS
Case Management, Certified Case Manager (CCM), Clinical Information, Compensation and Benefits, Corporate Policies, Cost Control, Maintain Compliance, Quality Management, Registered Nurse (RN), Regulations, Regulatory Compliance, Team Player
LOCATION
Sterling, VA
POSTED
14 days ago
Must reside in one of these cities: NOVA, Sterling, Reston, Chantilly, Oakton, HerndonPut the city, state, and zip at the top of the resume.Screenshot of unrestricted license at top of resume.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. Requires an RN with unrestricted active license 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
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