Case Manager- Remote Job in Actalent Oklahoma City, OK
Website Actalent
This Jobsfunter Listing is about Actalent in Oklahoma City, OK 2022
About the job
- Description:* Care Managers perform integrated case management (CM) and disease management (UM) activities demonstrating clinical judgment and independent analysis, collaborating with members and those involved with members’ care including clinical nurses and treating physicians. Care Managers determine, develop and implement a plan of care based on accurate and comprehensive assessment of the member’s needs. Care Managers apply detailed knowledge of established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case.
Responsibilities:
- Determines, develops and implements a plan of care based on accurate and comprehensive assessment of the member’s needs.
- Applies detailed knowledge of FEP PPO established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case.
- Works with complex cases, promotes the delivery of quality; cost-effective health care services based on medical necessity and contractual benefits.
- Provides guidance to the provider network.
- Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care.
- Makes referrals to Quality Management, Catastrophic Case Management and Appeals and Grievance Department.
- Skills:* Acute care, acute, nurse, clinical, healthcare
- Top Skills Details:* Acute care, acute, nurse, clinical, healthcare
- Additional Skills & Qualifications:*
- Bachelor’ s of Science in Nursing or advanced degree preferred.
- Active Oklahoma RN license required.
- Must have specialty training in one of the following specialized areas: case management, .
- 5 years experience in case management, utilization Review
- Experience Level:* Expert Level
About Actalent:
Actalent connects passion with purpose. Our scalable talent solutions and services capabilities drive value and results and provide the expertise to help our customers achieve more. Every day, our experts around the globe are making an impact. We’re supporting critical initiatives in engineering and sciences that advance how companies serve the world. Actalent promotes consultant care and engagement through experiences that enable continuous development. Our people are the difference. Actalent is an operating company of Allegis Group, the global leader in talent solutions. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Company: Actalent
Vacancy Type: Full-time · Associate
Job Location: Oklahoma City, OK
Application Deadline: N/A
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