Case Management Nurse Job at Computech Corporation, Kalamazoo, MI

OGo4K0NGK3NDNXU1ZTRRamdnV1VpQ1UwNkE9PQ==
  • Computech Corporation
  • Kalamazoo, MI

Job Description

Description:

(Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties)

Qualification

Duties:

  • Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
  • Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Experience :

  • 2 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
  • Healthcare and/or managed care industry experience.
  • Case Management experience preferred
  • Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
  • Effective communication skills, both verbal and written.
  • Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
  • Sedentary work involving periods of sitting, talking, listening.
  • Work requires sitting for extended periods, talking on the telephone and typing on the computer.
  • Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
  • Typical office working environment with productivity and quality expectations

Education :

  • RN with current unrestricted state licensure.
  • Case Management Certification CCM preferred

What days & hours will the person work in this position? List training hours, if different. : Mon-Fri 8am-5pm

Job Tags

Similar Jobs

Samsung SDS America

Logistics Business Operation/ Carrier Management (EM6954) Job at Samsung SDS America

 ...12 and has now grown into a global top-level third-party logistics company. This professional will handle various aspects of Carrier Management including sourcing, rates, quotes, analysis, negotiation, and bids according to company SOP. To learn more about Samsung... 

I C S

FAA Instructor (Must have FAA experience) Job at I C S

 ...FAA Education Instructor full time (Must FAA experience) Washington DC-Baltimore Area, DC Description INFINISOURCE CONSULTING SOLUTIONS (ICS) InfiniSource Consulting Solutions (ICS), a 150+ employee government contractor specializing in Management Consulting, Information... 

PacifiCorp

Student Engineer - Portland, Oregon #113859 Job at PacifiCorp

 ...medium and low voltage), bushings, control systems, dissolved gas analysis, excitation, generators (rewinding, modeling, testing, cleaning, painting), governors, load centers, motors (control, protection, replacement, sizing), NERC PRC & MOD, project management (appropriations... 

CitiStaffing

Litigation Legal Secretary - up to $100K! Job at CitiStaffing

Legal Secretary Dynamic Law firm has a great opportunity for someone with a very strong legal skills and experience to be a Legal Assistant/Legal Secretary to small team of senior attorneys. Responsibilities Include: Draft, edit, and prepare correspondence, ...

Michelli Weighing & Measurement

Field Service Technician - CDL Driver Job at Michelli Weighing & Measurement

 ...We are seeking a skilled Service Technician with a current CDL to join our team. The ideal candidate will be responsible for the installation...  ...and as part of a team to ensure high-quality service delivery to our clients. Responsibilities WORK SAFELY Accidents are...