Looking for the right candidate as Case Manager that will apply the six essential activities of Case Management (assess, plan, implement, coordinate, monitor and evaluate) to assure achievement of an individual’s maximum level of wellness. Through appropriate, quality, cost-effective alternative care delivery, the Case Manager will explore community resources and alternative funding in order to maximize healthcare benefit. The Case Manager will assist an individual to self-direct and self-advocate thus assurance of an informed and empowered healthcare consumer. CCM is required.
Some Knowledge and Skills Needed:
- Demonstrated success as a case manager with basic Utilization Review skills, as well as Managed Care Software knowledge
- Knowledge of the insurance industry, benefits coverage and claims processing
- Knowledge of case management principals, clinical guidelines and CMSA standards
- RN Degree or Diploma
- Current RN licensure in New Hampshire
- Case Management Certification (CCM)
- 3 years medical and/or surgical clinical experience
- 3 to 5 years case management or disease management experience
- Spanish a plus
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Posted 4 years ago