Full time Case Manager Nurse RN openings in the San Antonio, TX 78230 area with a major healthcare company! Starting ASAP!! Apply now with Luke H. at A-Line!
Day to Day Responsibilities of this Position:
- All telephonic.
- Completing an SIA assessment over the phone with foster parents (healthcare service plan).
- Make outreaches to foster parents to schedule appts to complete assessment, then complete, then additional appointments depending on how the assessment goes.
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
Pay: $35- $42 hourly
Work Shift: Mon-Fri 8am-5pm, some overtime – sometimes mandatory
- Graduate from an Accredited School of Nursing.
- Bachelor’s degree in Nursing preferred.
- 2+ years of clinical nursing experience in a clinical, acute care, or community setting.
- 1+ years of case management experience in a managed care 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.
- Licenses/Certifications: Current state’s RN license.
- 2+ years’ experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment.
- Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
- 401k after 1 year of employment: With employer match and profit sharing
- GREAT Hours! Monday through Friday, 40 hours per week
- Competitive Pay Rate
Keywords: CCM, InterQual, ICD-10, Medical Coding, BSN, Medical Management, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls.