Job Title: Case Manager Duration: 6 Months Shift timings: 8 AM- 5 PM EST Location: Remote, must be in approved states. (List of FTE states: NC, 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) Training: 4 weeks of training
****80 cases, 6 calls per day new engaging****
Job Description
Serve as a team member on a multidisciplinary team, coordinating care, resources andor 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 servicesproviders on plans for treatment, appropriate intervention andor discharge planning.
Develop a membercentric 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 followup with member, discussion of plan with member, appropriate serviceseducation to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plangoals 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 proactive 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.
Hiring Requirements
RN with 3 years of clinical and/or case management experience required. For some roles a Masters in Social Work with 5 years of related experience may be considered.
Must have and maintain a valid and applicable clinical license NC or compact multistate licensure to perform described job duties.
For some roles, additional specialty certification i.e. CCM, CDCES may be required.
If so, incumbents must obtain relevant certification within 2 years of employment.
About Us: Established in 2004, SPECTRAFORCE® is one of the largest and fastest-growing diversity-owned staffing firms in the US. The growth of our company is a direct result of our global client service delivery model that is powered by our state-of-the-art A.I. proprietary talent acquisition platform, robust ISO 9001:2015/ISO 27001 certified processes, and strong and passionate client engaged teams. We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 140 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation. SPECTRAFORCE is built on a concept of “human connection,” defined by our branding attitude of NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people and clients can reach their highest potential. Learn more at: http://www.spectraforce.com
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.
Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation. At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $42.43/hr.
