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• This RN Case Manager will be assisting members that have dual enrollment which means age 65 and over and have low income and resources 

• This RN Case Manager is a field case management position about 40% field the remainder of the time will be reporting to the North Charleston office if need be to perform assessments on members that have just signed up with the Medicare or Medicare plan

• This RN Case Manager will also be responsible for assessing, planning and coordinating all medical services especially MMT (Medicare Medical Transportation services) and supporting services across the continuum of care for select members to promote quality, cost effective car

• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and

provider options

• Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes

• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socioeconomic needs of clients

• 1+ years of clinical nursing experience in an acute care setting

• 1+ years of case management experience with the adult and geriatric population in a managed care, home health, Hospital, or Hospice setting

• Knowledge of utilization management principles and healthcare managed care

• Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs

Interested in hearing more about this great opportunity? Please click Apply or call Laura Cornelius 407-478-0332 ext. 107