Integrated Resources, Inc ( IRI )
Nurse Case Manager II
Integrated Resources, Inc ( IRI ), Providence, Rhode Island, United States
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Nurse Case Manager II
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Integrated Resources, Inc (IRI)
Get AI-powered advice on this job and more exclusive features. MUST HAVE:
RN With Current Unrestricted State Licensure In IL. REQUIRED 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 an unrestricted active license. Experience with case management and IL waiver services is preferred. Responsibilities include:
Conduct comprehensive assessments of referred members' needs/eligibility using clinical tools and data review. Interpret applicable criteria, guidelines, policies, and standards to ensure appropriate benefits administration. Utilize case management and quality management processes in compliance with regulations and policies. Position Summary:
The Case Manager assesses, plans, facilitates, and advocates for services to meet health needs, aiming for optimal outcomes with an active IL RN license. Duties include:
Act as liaison with members, families, providers, and insurance companies. Coordinate case management activities for catastrophic and chronically ill members, including referrals and community resources. Interact with members in various settings to provide ongoing case management. Develop care plans to facilitate appropriate management, wellness, and medical outcomes. Communicate with stakeholders and document all case work activities. Consult with medical providers and provide educational information. Ensure compliance with laws, regulations, and insurance requirements. Evaluate member needs and benefits, and monitor progress toward outcomes. Experience:
Minimum 3-5 years clinical experience, preferably with Medicare members in areas like diabetes, CHF, CKD, post-acute care, hospice, palliative care. 2-3 years of case management, discharge planning, or home health care coordination. Skills and Education:
Analytical, problem-solving, and effective communication skills. Ability to work independently, possibly from home. Proficiency in MS Office and proprietary applications. Registered Nurse with active license; Bachelor's degree preferred, with a plan to obtain within 3-5 years if only an associate's degree. Certified Case Manager preferred. Additional Information:
Seniority level: Mid-Senior level Employment type: Full-time Job function: Other Industries: IT Services and IT Consulting
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Nurse Case Manager II
role at
Integrated Resources, Inc (IRI)
Get AI-powered advice on this job and more exclusive features. MUST HAVE:
RN With Current Unrestricted State Licensure In IL. REQUIRED 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 an unrestricted active license. Experience with case management and IL waiver services is preferred. Responsibilities include:
Conduct comprehensive assessments of referred members' needs/eligibility using clinical tools and data review. Interpret applicable criteria, guidelines, policies, and standards to ensure appropriate benefits administration. Utilize case management and quality management processes in compliance with regulations and policies. Position Summary:
The Case Manager assesses, plans, facilitates, and advocates for services to meet health needs, aiming for optimal outcomes with an active IL RN license. Duties include:
Act as liaison with members, families, providers, and insurance companies. Coordinate case management activities for catastrophic and chronically ill members, including referrals and community resources. Interact with members in various settings to provide ongoing case management. Develop care plans to facilitate appropriate management, wellness, and medical outcomes. Communicate with stakeholders and document all case work activities. Consult with medical providers and provide educational information. Ensure compliance with laws, regulations, and insurance requirements. Evaluate member needs and benefits, and monitor progress toward outcomes. Experience:
Minimum 3-5 years clinical experience, preferably with Medicare members in areas like diabetes, CHF, CKD, post-acute care, hospice, palliative care. 2-3 years of case management, discharge planning, or home health care coordination. Skills and Education:
Analytical, problem-solving, and effective communication skills. Ability to work independently, possibly from home. Proficiency in MS Office and proprietary applications. Registered Nurse with active license; Bachelor's degree preferred, with a plan to obtain within 3-5 years if only an associate's degree. Certified Case Manager preferred. Additional Information:
Seniority level: Mid-Senior level Employment type: Full-time Job function: Other Industries: IT Services and IT Consulting
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