LanceSoft Inc.,
Registered Nurse - Case manager/ Case manager RN/Home health RN/Hospital RN
LanceSoft Inc.,, Lansing, Michigan, United States
Registered Nurse - Case Manager
Location: Remote/Travel within Michigan (Wayne, Macomb, Barry, Van Buren, Kalamazoo, Calhoun, Branch, St. Joseph, Cass, Berrien Counties). 50–60% travel required. Mileage will be reimbursed.
Position Summary 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.
Responsibilities
Provide comprehensive healthcare management services to facilitate appropriate treatment, effectively manage healthcare costs, and improve program/operational efficiency involving clinical issues.
Determine medical necessity and appropriateness.
Facilitate optimal outcomes and follow-through with continuous quality/compliance opportunities.
Educate and empower customers to ensure compliance, satisfaction, and promote patient advocacy.
Optimize total costs.
Implement and evaluate policy based on usage and program directives.
Educate and empower colleagues at all levels to enable decision‑making at the most appropriate level.
Conduct comprehensive assessments of referred members’ needs/eligibility using service coordination tools and clinical data review.
Apply applicable criteria and guidelines, standardized case management plans, and regulatory standards to ensure appropriate administration of benefits.
Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies.
Required Qualifications
3+ years of clinical practice experience in hospital or alternative care settings such as home health or ambulatory care.
Experience in the healthcare and/or managed care industry.
Case Management experience preferred; position requires proficiency with computer skills, including navigating multiple systems and keyboarding.
Effective verbal and written communication skills.
Ability to multitask, prioritize, and adapt to a fast‑paced, changing environment.
Experience with sedentary work involving periods of sitting, talking, listening, and typing.
Ability to perform close inspection of handwritten and computer‑generated documents on a PC monitor.
Education Registered Nurse (RN) with current unrestricted state licensure in Michigan. Case Management Certification (CCM) preferred.
Schedule Monday – Friday, 8:00 am – 5:00 pm EST.
Employee Benefits
Four options of medical insurance.
Dental and vision insurance.
401(k) contributions.
Critical illness insurance.
Voluntary permanent life insurance.
Equal Employment Opportunity LanceSoft is a certified Minority Business Enterprise (MBE) and an equal‑opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.
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Position Summary 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.
Responsibilities
Provide comprehensive healthcare management services to facilitate appropriate treatment, effectively manage healthcare costs, and improve program/operational efficiency involving clinical issues.
Determine medical necessity and appropriateness.
Facilitate optimal outcomes and follow-through with continuous quality/compliance opportunities.
Educate and empower customers to ensure compliance, satisfaction, and promote patient advocacy.
Optimize total costs.
Implement and evaluate policy based on usage and program directives.
Educate and empower colleagues at all levels to enable decision‑making at the most appropriate level.
Conduct comprehensive assessments of referred members’ needs/eligibility using service coordination tools and clinical data review.
Apply applicable criteria and guidelines, standardized case management plans, and regulatory standards to ensure appropriate administration of benefits.
Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies.
Required Qualifications
3+ years of clinical practice experience in hospital or alternative care settings such as home health or ambulatory care.
Experience in the healthcare and/or managed care industry.
Case Management experience preferred; position requires proficiency with computer skills, including navigating multiple systems and keyboarding.
Effective verbal and written communication skills.
Ability to multitask, prioritize, and adapt to a fast‑paced, changing environment.
Experience with sedentary work involving periods of sitting, talking, listening, and typing.
Ability to perform close inspection of handwritten and computer‑generated documents on a PC monitor.
Education Registered Nurse (RN) with current unrestricted state licensure in Michigan. Case Management Certification (CCM) preferred.
Schedule Monday – Friday, 8:00 am – 5:00 pm EST.
Employee Benefits
Four options of medical insurance.
Dental and vision insurance.
401(k) contributions.
Critical illness insurance.
Voluntary permanent life insurance.
Equal Employment Opportunity LanceSoft is a certified Minority Business Enterprise (MBE) and an equal‑opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.
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