Nurse Case Manager I, II, California (Future Telecommuting)
Location: California
Description: WellPoint, Inc is presently looking of Nurse Case Manager I, II, California (Future Telecommuting) right now, this position will be placed in California. Detailed specification about this position opportunity please give attention to these descriptions. WellPoint is one of the nations leading health benefits insurers and a Fortune Top 50 company. At WellPoint, we a! re dedicated to improving the lives of the people we serve and the health of our communities. WellPoint strives to simplify the connection between health, care, and value for our customers.
Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to take your career further than you can imagine.
We have multiple positions available!
Location : (Anywhere in California) - Telecommuting available once training is fully completed and the individual has demonstrated the ability to work independently.
The Nurse Case Manager in this position performs care management within the scope of licensure for WellPoint senior market members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate! to their health needs. Primary duties may include, but are no! t limited to:
Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
Coordinates internal and external resources to meet identified needs.
Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
Assists in problem solving with providers, claims or service issues.
Job Qualifications
Qualified candidates must have:
a current unrestricted state RN license, BSN preferred, and at least 3 years of pertinent clinical experience.
At least 5 years clinical experience strongly preferred.
Case managemen! t certification (CCM) preferred.
Case management, med/surge, home health and/or discharge planning experience preferred.
Knowledge of Medicare a plus
Requires knowledge of care management assessment techniques, provider community, and community resources.
Must have strong oral, written and interpersonal communication skills, PC skills to include word processing, spreadsheet, and database applications, organizational and problem-solving skills, and decision-making skills.
As business needs may require, this position may require additional state licenses either now or in the future. Inability or unwillingness to obtain these required licenses may result in either re-assignment (if available) or termination. Obtaining required licenses is a requirement for continued employment.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to WellPoint, Inc.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Sat, 17 Aug 2013 16:12:25 GMT
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