Spanish Speaking RN Case Manager
Company: Actalent
Location: Miami
Posted on: January 28, 2023
Job Description:
Description:
- Responsible for performing care management within the scope of
licensure for members with complex and chronic care needs by
assessing, developing, implementing, coordinating, monitoring, and
evaluating care plans designed to optimize member health care
across the care continuum.
- Performs duties telephonically or on-site such as at hospitals
for discharge planning.
- Primary duties may include, but are not limited to: Ensures
member access to services appropriate to their health needs.
Conducts assessments to identify individual needs and a specific
care management plan to address objectives and goals as identified
during assessment.
- Implements care plan by facilitating authorizations/referrals
as appropriate within benefits structure or through
extra-contractual arrangements.
- Coordinates internal and external resources to meet identified
needs.
- Monitors and evaluates effectiveness of the care management
plan and modifies as necessary.
- Interfaces with Medical Directors and Physician Advisors on the
development of care management treatment plans.
- Negotiates rates of reimbursement, as applicable.
- Assists in problem solving with providers, claims or service
issues.Skills:RN, Case manager, CCM, Certified Case Manager, EMR,
Care management, Case management, BilingualTop Skills
Details:RN,Case managerAdditional Skills & Qualifications:
- Requires a BA/BS in a health related field
- 3 years of clinical experience (or any combination of education
and experience)
- Current, unrestricted RN license in applicable state(s)
required.
- Multi-state licensure is required if this individual is
providing services in multiple states.
- Certification as a Case Manager is preferredAbout Actalent:
Actalent connects passion with purpose. Our scalable talent
solutions and services capabilities drive value and results and
provide the expertise to help our customers achieve more. Every
day, our experts around the globe are making an impact. Were
supporting critical initiatives in engineering and sciences that
advance how companies serve the world. Actalent promotes consultant
care and engagement through experiences that enable continuous
development. Our people are the difference. Actalent is an
operating company of Allegis Group, the global leader in talent
solutions.The company is an equal opportunity employer and will
consider all applications without regards to race, sex, age, color,
religion, national origin, veteran status, disability, sexual
orientation, gender identity, genetic information or any
characteristic protected by law.
Keywords: Actalent, Miami , Spanish Speaking RN Case Manager, Executive , Miami, Florida
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