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1 - 25 Results of 44
Lumeris
New Jersey, United States
22 days ago

Description

The Complex Case Manager at Lumeris will provide telephonic care and case management to  members as part of a multidisciplinary care team. The Complex Case Manager will offer members health and disease education and empower them to actively participate in their care. Other duties of the Complex Case Manager include but are not limited to: consultation with members on their medications and durable medical equipment, review member care plans, address home care needs, and connect members to community resources; collaboration with primary care physicians and other providers to ensure there are no gaps in care; collaboration with members, providers, and care givers to ensure positive care outcomes during care transitions.

Role and Responsibilities

  • Make outbound calls to assess member’s current health status
  • Provide patient education to assist with self management
  • Educate members on disease processes
  • Encourage members to make healthy lifestyle changes
  • Identify gaps or barriers in treatment plans
  • Coordinate care for members
  • Make referrals to outside sources
  • Coordinate services such as home health, DME, as needed
  • Ensure that discharged members receive the necessary services and resources, including medication reconciliation      
  • Document and track findings in a computerized system
  • Interact with providers and a multi-disciplinary care team
  • Collaborate with medical management staff in development of new programs

*This is a work from home position 



Requirements

Experience, Qualifications, and Education

Required:

  • Current licensure as a registered nurse in the state of New Jersey and eligibility for licensure in other states  
  • Two years minimum experience in a hospital setting or home health case management
  • Must be proficient with computers, have the ability to type and talk simultaneously, and have excellent interpersonal and customer service skills, including telephone etiquette. 
  • Must be able to multi-task and prioritize on a daily basis
  • Must be flexible and adaptive to a changing environment

 Preferred:

  • Previous experience as a telephonic case manager for an insurance plan  
  • Case management certification
  • BSN or experience with discharge planning
  • Experience in program development

Job Information

  • Job ID: 58466476
  • Location:
    New Jersey, United States
  • Position Title: RN, Case Manager
  • Company Name: Lumeris
  • Job Function: Nursing
  • Job Type: Full-Time
  • Job Duration: Indefinite
  • Min Experience: 2-3 Years
  • Required Travel: 0-10%

Please refer to the company's website or job descriptions to learn more about them.

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