Transplant Case Manager IV

🕒 il y a 3 jours

🌵 Arizona, Florida, +15 états de plus – Distant

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💵 $80 700 - $109 535 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

🦅 Parrain de Visa H1B

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👻 Score fantôme 0%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Medica

Medica

1001 - 5000 employés

Fondée en 1975

🏥 Santé

🛡️ Assurance

⚕️ Assurance santé

Healthcare • Insurance • Healthcare Insurance

Medica est un organisme de santé à but non lucratif et assureur avec plus de 50 ans d'expérience, offrant des plans individuels et familiaux, ainsi que des plans de santé pour les entreprises, Medicare et Medicaid. Il propose des services aux membres et des outils pour trouver des prestataires, gérer les avantages et les réclamations, des programmes de bien-être ainsi que des initiatives orientées vers la communauté à travers la Fondation Medica pour promouvoir l'équité en santé.

Description

• Provide member-centered, evidence-based case management across Medicare Advantage, State Public Programs, Commercial, and Individual and Family products • Serve members with the highest needs and help them navigate the health system telephonically • Understand each member's care goals • Coordinate care across multiple providers • Assist members with finding community resources • Reduce illness burden for individuals and families while decreasing healthcare costs • Ensure members with complex illness are aware of their plan of care • Ensure providers and Medica care management services are aware of the plan of care • Establish care management accountabilities and hold resources accountable • Engage members and provider care teams in care plan discussions • Engage members and families • Design and implement targeted programs

🎯 Exigences

• Associate's or Bachelor's degree in Nursing • 5+ years of clinical/acute care experience • Current, unrestricted RN license in the state of residence • Certified Case Manager (CCM) preferred, or ability to obtain within two years of hire • Utilization Management / Prior Authorization experience helpful, but not required • Advanced experience in targeted transplant programs • Experience managing multiple computer systems and tools • Experience working with various populations, age groups, ethnic and socioeconomic backgrounds, and medical and surgical backgrounds • Generalized understanding across specialty care areas • General working knowledge of the health care continuum • Strong communication, decision-making, customer service, verbal, and written skills • Ability to present in a group setting • Ability to negotiate and access resources • Ability to work in a fluid, ever-changing, fast-paced environment • Ability to make decisions under stress and manage multiple complex issues daily • Must be legally authorized to work in the United States; Medica does not offer work visa sponsorship

🏖️ Avantages

• Competitive medical, dental, and vision coverage • PTO • Holidays • Paid volunteer time off • 401K contributions • Caregiver services • Other total rewards benefits

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