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Nurse Care Manager needed for a permanent opportunity with Yoh's client located in Portland, OR!
Top Skills You Should Possess:
Experience in Care Management, Case Management or Disease Management
What You'll Be Doing:
Advocate for the patient and his/her family while adhering to the overall treatment plan, UR/UM guidelines, and policies and procedures of the facility
Perform assessments on assigned population and develop plans based on the needs of the patient/family
Work collaboratively with the interdisciplinary team to promote high quality care provided in a timely and fiscally responsible manner; ensure that the patient's care is coordinated across the continuum by collaborating and communicating with the patient's medical home and/or other healthcare providers
Identify barriers that impact adherence to the plan of care and provide intervention or makes referrals as indicated
Provide clinical information as needed to assist in obtaining authorization for services; ensures admission, surgery, and designated level of care orders reflect medical necessity documentation; obtain authorizations for post-hospital care and services as required by patient's benefits, entitlement programs, or charitable resources
Provide guidance about health care benefits and assess financial barriers; address gaps in healthcare coverage and make referrals as needed
What You Need to Bring to the Table:
Current Oregon RN license
Bachelors degree in Nursing or related field preferred
Certified Case Manager - CCM - preferred
Five (5) years of pediatric clinical experience, preferably in one or more of the following areas: orthopedics, neuromuscular conditions, post burn, cleft lip palate revisions
Three - five (3-5) years experience in Care/Case Management, applying a working knowledge of community resources, entitlement programs; working with uninsured/underinsured patient populations is preferred
Experience with utilization review/management with a working knowledge of InterQual criteria is strongly preferred
Experience with disease management and application of motivational interview techniques
Competency in computerized documentation systems is required
Opportunity is Calling, Apply Now!
Recruiter: Jennifer Andersen
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Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Click here to contact us if you are an individual with a disability and require accommodation in the application process.