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Remote Case Management Processor Jobs in Florida

MedWatch, LLC

Case Manager / RN

Lake Mary, FL · On-site +1

$72K - $81K/yr

... case management process in order to meet the needs of the MedWatch, LLC customers and consumers ... This is a remote/work-from-home position. License Requirements : * Registered Nurse (current active ...

Valeris

Executive Case Manager (Remote)

Orlando, FL · Remote

This is a remote role. Candidates must reside in the state of Florida. When you join the team as an ... processes and procedures. Key Responsibilities: * Relationship Management * Builds trusted ...

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Remote Case Management Processor information

What is the difference between Remote Case Management Processor vs Remote Claims Processor?

AspectRemote Case Management ProcessorRemote Claims Processor
CredentialsTypically requires case management certifications or healthcare-related credentialsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare or social services settings, remote or office-basedInsurance companies, healthcare providers, remote or office-based
Industry UsageHealthcare, social services, insuranceInsurance, healthcare, financial services
Job FocusManaging patient or client cases, coordinating servicesProcessing insurance claims, verifying coverage

While both roles involve processing information remotely, the Remote Case Management Processor focuses on managing client cases and coordinating services, often in healthcare or social services. In contrast, the Remote Claims Processor primarily handles insurance claims, verifying coverage and processing payments. Understanding these differences helps job seekers identify the right role based on their credentials and career interests.

What are the most commonly searched types of Case Management Processor jobs in Florida? The most popular types of Case Management Processor jobs in Florida are:
What cities in Florida are hiring for Remote Case Management Processor jobs? Cities in Florida with the most Remote Case Management Processor job openings:
Remote Case Management Processor jobs near you
Remote Case Manager - Integrated Care

Remote Case Manager - Integrated Care

Integrated Resources INC

Fort Lauderdale, FL • Remote

Full-time

Posted 18 days ago

Job description

Job Description

TITLE: REMOTE CASE MANAGER - INTEGRATED CARE.
LOCATION: FORT LAUDERDALE, FL. 33304.
DURATION: 6+ MONTHS.
LICENSE: LCPC, LCSW OR RN. THE RN REQUIRES A MIN. BACHELOR'S DEGREE. ALL OF OTHER LICENSES REQUIRES A MASTER'S DEGREE.
TEMP-TO-PERM REMOTE POSITION.
HOURS: 8 AM - 5 PM.
ESSENTIAL FUNCTIONS:

Completes relevant screening and assessment. Ensures continuity of care for newly enrolled members. - Identifies and prioritizes the members' needs and preferences. Develops quantifiable goals and desired outcomes, and promotes the member ability to self-manage to the greatest extent possible.

Develops, implements and monitors the Person-Centered Service Plan, assisting members in obtaining reasonable accommodations when appropriate. - Manages case load, including risk stratification of members, monitoring reassessment needs and facilitating transitions of care settings. - Serves as the primary point of member contact.

Assesses member needs, manages care and services, and ensures effective communication among members, caregivers, providers and community supports. - As the lead of the interdisciplinary team facilitates the activities and communication within an interdisciplinary team of providers, vendors, facilities, discharge planners, field nurses, social workers, care coordinators, and member/caregivers to effectively manage care plans and transitions of care settings.

Maintains timely, complete and accurate documentation using both hard copy and technology based solutions in compliance with regulatory policies and procedures. - Gathers and summarizes data for reports. - Supports initiatives of the Quality Assessment and Performance Improvement Committee. - All other duties as assigned.

Additional Information

REQUIREMENTS/CERTIFICATIONS:

Candidates must be local to the Fort Lauderdale, FL area, which is in Broward, County. There are occasional field visits with an average of 1 or 2/week.


ADDITIONAL INFORMATION:

Coordinating Care, Case Management, Clinical, and Medicaid experience will stand out of the resumes for the manager. Candidates must be comfortable with working in a cubicle environment, comfortable with typing and talking at the same time and comfortable navigating through multiple systems.

MUST be computer literate. To be successful in the position, the selected candidate must be able to apply principals of Care Management and Person Centered Service Planning, apply Care Guidelines and other applicable, evidenced-based clinical guidelines, understand and apply coverage guidelines and benefit limitations, be familiar with clinical needs and disease processes for the member and lead an interdisciplinary care team.

Responsible for the assessment, reassessment, care planning and coordination of care and services. Includes ongoing monitoring of an appropriate and effective person-centered care plan, member education, and care management. Regularly communicates with the members, PCP and other.

The successful candidate will have strong organizational skills and have the ability to prioritize and follow through on multiple projects in a timely manner.


LICENSE:

LCPC, LCSW OR RN. THE RN REQUIRES A MIN. BACHELOR'S DEGREE. All of other licenses requires a Master's Degree.

Integrated Resources logo

About Integrated Resources

Sourced by ZipRecruiter

Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Edison, NJ, US

Year founded

1996

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