Care Manager II RN -- Medicaid HMO/Pediatrics
Location: North Charleston, South Carolina
Description: AMFC is at present looking to employ Care Manager II RN -- Medicaid HMO/Pediatrics right now, this position will be designated in South Carolina. For detail informations about this position opportunity please give attention to these descriptions. Under the supervision of the Supervisor ICM, the Pediatric Care Manager II assists members with appropriate care ! coordination and case management services to achieve their optimal levels of health. The Care Manager is responsible for engaging members and providers to assess, plan and establish individual member goals. The Care Manager will facilitate and coordinate care for members while assuring quality and use of cost-effective resources. The Care Manager will function as a single point of contact and be an advocate for members in the care coordination program.
The ideal candidate for this position will have recent experience in Pediatric Nursing and or Pediatric Care Management.
Principal Accountabilities are but not limited to:
Assesses members to determine care coordination and case management needs for all referred members.
Completes comprehensive assessments of environmental, psycho-social and support needs.
Identifies problems/barriers for care coordination and appropriate care management interventions.
Creates a plan of care to assist ! members in reducing/resolving problems and or barriers so that! members may achieve their optimal level of health.
Identifies both short and long term goals and associated time frames for completion.
Shares goals with members and their families as appropriate.
Identifies and implements the appropriate level of intervention based upon the member’s needs and clinical progress.
Schedules follow-up calls as necessary and makes appropriate referrals to management.
Implements actions to address member issues.
Documents progress towards meeting goals and resolving problems.
Coordinates care and services with members and family members as appropriate, PCP’s, specialists and facility/vendor providers.
Collaborates with department staff to assist members in receiving quality and cost effective services.
Facilitates access to entitlement programs and/or community resources.
Monitors and documents member’s on going progress.
Conducts hospital and home visits as necessary.
Participates in the di! scharge planning process for hospitalized members.
Assists members in the transitional process from home to a skilled nursing facility for long-term placement.
Arranges for services/appointments.
Participates on project teams as requested.
Maintains confidentiality of all company, provider and member information.
Identifies and refers potential and actual quality issues to quality management staff.
Keeps up-to-date with case management initiatives.
Attends scheduled meetings.
Obtains necessary educational requirements to maintain professional licensure and certifications.
Complies with ACFC and HIPAA confidentiality requirements to protect member personal identifiable health information.
Performs other related duties and projects as assigned.
Adheres to ACFC policies and procedures.
Supports and carries out the Caritas Mission & Values.
Attends required training on an annual basis.
Position Qualifications/Requi! rements:
Education and Training:
Registered Nurse, D! iploma, Associates, Bachelors Degree in Nursing
Bachelor's Degree preferred
Licenses, Registrations or Certification:
Active/Unrestricted South Carolina RN license.
Valid driver’s license with car insurance
Must apply for Care Management Certification within two years of accepting position.
Experience:
Minimum of 3+ years of Care Management experience preferred.
Pediatric nursing / care management experience highly preferred.
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If you were eligible to this position, please deliver us your resume, with salary requirements and a resume to AMFC.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position starts available on: Mon, 24 Jun 2013 03:59:10 GMT
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