Field Case Manager

Pay Range: $44.12 / hour

Work Setting: Remote, Michigan (Wayne and Macomb Counties.)

Job Duties:

• Utilize a collaborative process of assessment, planning, facilitation, and advocacy to meet members’ health needs and benefit plans
• Conduct comprehensive assessments of referred members’ needs and eligibility using clinical tools and data review
• Determine appropriate approaches to case resolution by evaluating benefit plans and available internal/external programs and services
• Apply and interpret applicable criteria, guidelines, and standardized case management plans
• Ensure appropriate administration of benefits in alignment with policies, procedures, and regulatory standards
• Facilitate communication among members, providers, and resources to promote optimal, cost‑effective outcomes
• Integrate case management and quality management processes in compliance with accreditation guidelines and company policies
• Document assessments, plans, and interventions accurately and in accordance with organizational standards
• Advocate for members to ensure access to appropriate services and resources
• Monitor and evaluate outcomes to support continuous improvement in care delivery

Requirements:

• RN with current unrestricted state licensure for MI.
• Case Management Certification CCM preferred
• 3 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

Contract Length: 3 months

Working Days: Monday-Friday

Working Hours: 8am-5pm EST

To Apply download our app 360X JOBS, visit our website www.360xstaffing.com and click "Join our Team".

Pay: $44.12 per hour

Work Location: Remote

Salary : $44