Insurance Case Manager Jobs in Biloxi, MS (NOW HIRING)

Responsibilities

• The Nurse Case Manager shall provide a full range of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope of problems associated with providing appropriate, cost effective care to Department of Defense (DOD) beneficiaries.
• The Case Manager shall collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history in order to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations.
• The Case Manager shall assess patient via the telephone, using established protocols, in order to provide appropriate and cost effective care.
• The Case Manager shall establish priorities for patient care monitor and evaluate progress toward the stated goals in order to provide coordinated, efficient, effective health care to its beneficiaries.
• The Case Manager shall oversee discharge-planning activities in order to ensure ideal timing and sequencing of patient care.
• The Case Manager provides professional assistance to health care finders in order to identify patient's needs for referrals to appropriate health care providers or facilities.
• The Case Manager shall negotiate, write, finalize, and administer product/service agreements to insure mutual compliance in meeting care goals.

Qualifications

• The contractor shall have demonstrated skill in understanding diagnoses in order to assist patients to optimize their level of function and self-care.
• The contractor shall possess demonstrated knowledge of patient education principles and management of complex medical, psychosocial, and financial problems in order to enhance patient adherence to individualized treatment plans and train peers and staff.
• The contractor shall have a minimum of two years nursing experience and shall be certified as a case manager by a recognized certifying organization, i.e. Commission for Case Management Certification or American Nurse Credentialing Center.
• The contractor shall possess the ability to seek feedback from peers, professional colleagues, clients, and outcomes research, in order to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues.
• The contractor shall have the skills to effectively consult with health care providers at all levels and negotiate with outside providers for services and products in order to obtain client services and support.
• Contractor may be required to receive and maintain clinical practice privileges.
• The contractor shall maintain credentialing requirements in good standing at a local MTF.

Experience

• The contractor shall have a minimum of two years nursing experience.

Licensure

• Licensure: Current, full, active, and unrestricted license as a Registered Nurse in one of any U.S. State, the District of Columbia, Guam, Puerto Rico or U.S. Virgin Islands.
• All HCPs shall have and maintain current certification in Basic Cardiac Life Support (BCLS) as certified by the American Heart Association. Documentation of such training shall be provided to the COR. The front and back of the BCLS shall be provided to the Credentialing Department of the MTF they are credentialed through.

About Loyal Source

Loyal Source provides healthcare and technology solutions designed to improve outcomes and support mission-critical operations. Guided by innovation and purpose, we help organizations achieve success across complex challenges worldwide. Loyal Source is a military friendly employer and proud partner of the Military Spouse Employment Partnership program.

Loyal Source uses AI-powered voice screening as part of our application process. After you apply, you will receive a brief qualification survey via text or email. Candidates who meet the position requirements will then be invited to complete a quick AI-powered voice assessment. This easy, no-scheduling-required process helps us and the candidate move the hiring process forward faster.

We are committed to providing equal employment opportunities to all applicants. If you have a disability or medical condition and need a reasonable accommodation to participate in this step of the hiring process, you may request an alternative method or accommodation at any time by contacting Human Resources at HRmgt@loyalsource.com.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation by contacting HR at HRmgt@loyalsource.com. If you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability, please select the accessibility menu to the (right or left) for more assistance. You can also request reasonable accommodations by contacting a telecommunications relay service by dialing 711 for direct access and assistance (tty).

This contractor and subcontractor abides by the requirements of 41 CFR 60-300.5(a) and 41 CFR 60-741.5(a). These regulations prohibit discrimination against qualified individuals on the basis of protected veteran status or disability, and require affirmative action by covered prime contractors.