Nurse Case Manager - RN
Software Galaxy Systems, LLC
- Richmond, VA
- 1 day ago
- $45–$46 Per Hour
- Contractor
- Full-time
Want to know if you’re a fit?
Upload your resume and let our AI show you.
Upload your resume and let our AI show you.
Skills
- Case Managementunmatched
- Certified Case Manager (CCM)unmatched
- Compensation and Benefitsunmatched
- Cost Controlunmatched
- Registered Nurse (RN)unmatched
- Team Playerunmatched
Description
Position Summary:
- The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
- Requires an RN with unrestricted active license in VA.
Job Responsibilities
Duties:
- Through the use of Clinical Tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.
- Application and/or Interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate
administration of benefits - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Numbers & Facts
| Location | Richmond, VA |
| Job Type | Contractor, Full-time |
| Salary | $45–$46 Per Hour |
| Year Founded | null |
| Headquarters | Princeton, NJ, US |
| Website | https://www.sgsconsulting.com |
Qualifications
Experience:
- 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.
Education:
- Requires an RN with unrestricted active license (no history) in NJ (compact licensure)
- Case Management Certification CCM preferred
Skills
- Case Management
- Clinical Assessment
- Home Care
- Alternative Care
- Home Health
About Company
Software Galaxy Systems, LLC (SGS Consulting) is a Workforce Solutions organization providing a broad range of integrated suite of services through our global delivery platform. SGS brings unparalleled innovative IT services strategies to empower its clients to stay focused on growth of their core business.