Case Manager II
Company Name:
Centene
## Description
Position Purpose:
Perform collaborative duties to assess, plan and coordinate continuum of care for select members with complex medical or behavioral health conditions or are at high risk in order to promote quality, cost effective care.
Position
Responsibilities:
Advanced review of admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care.
Develop, assess and adjust as necessary the care plan and promote desired outcome.
Coordinate services between Primary Care Physician (PCP) specialist, and other medical and non-medical providers as necessary to meet the complete medical socio economic needs of clients. Participate in face to face visits with high risk members at point of service as needed. For BCHP only, participate in face to face visits with high risk members at point of service .
Provide patient and provider education.
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Data enters assessments and authorizations into the system.
## Qualifications
Knowledge/
Experience:
2
years of clinical nursing or case management experience. 2
years of related experience in managed care environment.
Licenses/Certifications:
Current state's RN license, LCSW or LMSW. Current state driver's license. CCM (Certified Case Manager) or other clinical certification preferred.
## Job
Job: Clinical
Primary Location: USA-Ohio-Akron
Other Locations: USA-Centene-Centene
Organization: Buckeye Community Health Plan
Schedule: Full-time
Req ID: 005VCEstimated Salary: $20 to $28 per hour based on qualifications.
Centene
## Description
Position Purpose:
Perform collaborative duties to assess, plan and coordinate continuum of care for select members with complex medical or behavioral health conditions or are at high risk in order to promote quality, cost effective care.
Position
Responsibilities:
Advanced review of admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care.
Develop, assess and adjust as necessary the care plan and promote desired outcome.
Coordinate services between Primary Care Physician (PCP) specialist, and other medical and non-medical providers as necessary to meet the complete medical socio economic needs of clients. Participate in face to face visits with high risk members at point of service as needed. For BCHP only, participate in face to face visits with high risk members at point of service .
Provide patient and provider education.
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Data enters assessments and authorizations into the system.
## Qualifications
Knowledge/
Experience:
2
years of clinical nursing or case management experience. 2
years of related experience in managed care environment.
Licenses/Certifications:
Current state's RN license, LCSW or LMSW. Current state driver's license. CCM (Certified Case Manager) or other clinical certification preferred.
## Job
Job: Clinical
Primary Location: USA-Ohio-Akron
Other Locations: USA-Centene-Centene
Organization: Buckeye Community Health Plan
Schedule: Full-time
Req ID: 005VCEstimated Salary: $20 to $28 per hour based on qualifications.
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