RN Case Manager

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🕒 Outubro 1

🤠 Texas – Remoto

🤠 Texas – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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👻 Score fantasma 29%

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• Aberta há 42 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.
• Sem salário divulgado.

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GuideWell Source

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏥 Saúde

💼 Consultoria

⚕️ Seguro de Saúde

Healthcare • Consulting • Healthcare Insurance

A GuideWell Source é uma empresa do Grupo GuideWell que se concentra em acelerar soluções inovadoras de saúde no mercado, transformando e remodelando a indústria da saúde. Especializa-se na prestação de assistência médica, proporcionando novos modelos e resultados superiores para os pacientes. A empresa enfatiza o consumerismo na área da saúde, engajando clientes de maneiras significativas. A GuideWell Source oferece seguros de saúde, protegendo empregadores e consumidores com planos de cobertura e serviços. A empresa também fornece serviços de administração e processamento de sinistros para programas estaduais e federais de Medicare e Medicaid, estabelecendo-se como um parceiro de negócios confiável no setor de saúde com foco na excelência operacional.

Descrição

• Create, implement, and monitor treatment plans to help patients/members meet healthcare goals • Assess members’ health status and care coordination needs • Perform inpatient review, discharge planning, and possible outpatient management • Contact patients, families, physicians, healthcare providers, community resources, provider business offices, and employers/clients • Identify and coordinate alternative treatment plans within quality-care and cost-containment guidelines • Assess clinical status and sequelae to coordinate appropriate services • Monitor health status and treatment-plan impact, adjusting care plans as client needs change • Identify services, resources, providers, and facilities that best serve members in a timely and cost-effective manner • Develop and implement short- and long-term case management goals with documented care plans • Evaluate treatment-plan cost effectiveness before and after implementation • Produce accurate and timely reporting • Review medical records to determine medical necessity • Interpret individual health plans and authorize or coordinate care according to plan provisions

🎯 Requisitos

• Ability to work Monday to Friday, 9a-6p CST or 10a-7p CST • California RN state license • 5+ years related work experience with a professional background in clinical nursing and patient assessment • Related Bachelor’s degree or additional related equivalent work experience • Graduate of an accredited school of nursing • RN - Registered Nurse - State Licensure • Knowledge of medical terminology, reasonable and necessary treatment plans, delivery quality health care services and cost containment practices • Ability to collaborate with cross-operational areas within the organization • (CCM) Certified Case Manager preferred • Compact State Licensure in good standing preferred • Prior experience in utilization management or case management, preferably within the managed care environment, preferred • Intensive care or higher-acuity patient experience preferred • Knowledge of managed care in a self-funded employer population preferred • Ability to identify problems such as underutilization or overutilization of services • Ability to promote and maintain quality care through analysis

🏖️ Benefícios

• Medical, dental, vision, life and global travel health insurance • Income protection benefits: life insurance, Short- and long-term disability programs • Leave programs to support personal circumstances • Retirement Savings Plan includes employer contribution and employer match • Paid time off, volunteer time off, and 11 holidays • Additional voluntary benefits available • Comprehensive wellness program

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