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Complex Case Management Nurse - RN

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 Job Snapshot
Location : 
9245 N Meridian
Indianapolis, IN 46204 (map it!Map it!)
Employee Type : 
Full-Time
Industry : 
Healthcare - Health Services
Managed Care
Manages Others : 
No
Job Type : 
Nurse
Health Care
Education : 
4 Year Degree
Experience : 
At least 3 year(s)
Travel : 
None
Post Date : 
5/1/2013
 Description RepuCare is a woman owned business and a leading provider of medical management solutions for state, federal and corporate healthcare programs. We are partnered with a large healthcare company to provide medical management staff to support their state sponsored Medicaid managed care program.

Complex Case Management Nurse performs collaborative duties to assess, plan and coordinate continuum of care for select members with complex medical or behavioral conditions or are at high risk in order to promote quality, cost effective care.

Specific responsibilities include:
  • Advanced review of admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care
  • Develop, assess and adjust the care plan and promote desired outcome
  • Coordinate services between primary care physician, specialist and other providers to meet the complete medical socio economic needs of clients.
  • Provide patient and provider education
  • Identify related risk management quality concerns and report to appropriate resources
  • Data entry of assessments and authorizations

 

RepuCare provides a comprehensive benefits program including medical, PTO and 401K for full-time employees.

 

 Requirements
  • Current, unrestricted Indiana RN license
  • 3+ years clinical practice
  • 2+ years managed care experience
  • Medical case management experience
  • CCM (Certified Case Manager) or other clinical certification preferred
  • Critical thinking skills
  • Strong technical and professional knowledge
  • Excellent oral, written and interpersonal skills
  • Good PC skills
  • Team player, customer service skills
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