Managing project and process management at Paracelsus Kliniken, a healthcare provider in Germany. Creating efficient processes and accompanying the digital transformation at clinic locations.
About the role
- Nurse Case Manager II managing complex care needs, assessing and implementing care plans for members in Louisiana. Providing services telephonically or on-site in community settings.
Responsibilities
- Responsible for care management within the scope of licensure for members with complex and chronic care needs
- Assess, develop, implement, coordinate, monitor, and evaluate care plans designed to optimize member health care
- Perform duties telephonically or on-site such as at hospitals for discharge planning
- Ensure member access to services appropriate to their health needs
- Conduct assessments to identify individual needs and a specific care management plan
- Implement care plan by facilitating authorizations/referrals as appropriate
- Coordinate internal and external resources to meet identified needs
- Monitor and evaluate effectiveness of the care management plan
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Negotiate rates of reimbursement as applicable
Requirements
- Requires BA/BS in a health related field
- Minimum of 5 years of clinical experience
- Current, unrestricted RN license in applicable state(s) required
- Multi-state licensure is required if providing services in multiple states
- Certification as a Case Manager is preferred
- Experience with working with the homeless and substance use disorders preferred
- Experience with Adult population with Chronic Conditions preferred (e.g., Diabetes, Sickle Cell, Congestive Heart Failure, Hepatitis, HIV, and Hypertension)
- Experience in hospital, case management, MCO preferred
Benefits
- Health insurance
- 401(k) +match
- Stock purchase plan
- Life insurance
- Wellness programs
- Financial education resources
- Paid holidays
- Paid Time Off
- Merit increases
- Incentive bonus programs
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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