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Case Manager Registered Nurse job

Tailored Management jobs

Company

Salary

Skills

Company Description

Tailored Management is a professional staffing firm with headquarters located in Ohio. It is committed to developing a strong relationship with career seekers. and partnerships with clients. Its mission is to open a door of opportunity for clients, customers, candidates, and associates. It offers custom staffing, recruiting focus, and a centralized recruiting hub. Its core values are integrity, accountability, loyalty, teamwork, respect, excellence, and diversity. It is an equal opportunity employer. It offers a range of benefits that include medical, dental, life, and disability coverage, vacations, paid holidays, health savings account. It is offering career opportunities for senior account manager and payroll specialist position.

Job Description

Job Description

Address: 2208 North Highway 121, Bedford, Texas 76021 (Suite 210) *remote during COVID19*
Hours: Monday-Friday 8:00AM-5:00PM
Pay: $40.29/hour paid every Friday
Duration: 05/04/2020 to 12/31/2020 (extension and permanent placement depending on attendance and performance)
Openings: 2

Overall Responsibilities:

  • The position is responsible for the efficient execution of the medical utilization and/or the case management quality program activities as well as management of the URAC & NCQA utilization and case management accreditation survey project(s).
  • Implementation of robust quality program activities to support the Project Improvement Projects as required by the state and ensure that business partner collaboration and venues are in place to facilitate an improvement-driven quality program for the medical management programs; active participation on other quality committees to ensure effective monitoring mechanisms are in place

Essential Responsibilities:

  • Report on result sharing of findings and outcomes to NCQA, State and PIP to leadership as directed by the initiative and when indicted collaboration.
  • Support the risk management leadership on any identified risks and issue resolution.
  • Provide oversight annual training in NCQA and other accreditation requirements.
  • Management and development of Standard Operating Procedures (SOPs), accreditation, compliance policies and Job aides, ensure remediation or corrective action plan or act on improvement opportunities
  • Function as a resource to the organization on the accreditation standard requirements for the utilization and case management programs; actively participate on matrix area project teams, as needed.
  • Oversight of quality improvement projects implementation, development and reporting including measure development, data collection, that include quantitative and qualitative analysis and reporting, and performance improvement initiatives.
  • Ensures oversight collaboratively with operational/delivery systems/IT departments, creates Accreditation and PIP processes and strategies that focus on the specific health needs of the population.
  • Collaborates and provides recommends on any updates to the Care Management leadership any updates on the Accreditation, State, MOC and other CMS required documents
  • May attend outside meetings, including legislative, state officials, agency, and/or community meetings and serve as point of contact and liaison between state and federal agencies and the Company.
  • Performs other duties as assigned

Qualifications:

  • Registered Nurse, with active licensure and no restrictions,
  • Ability to pass 7-year county background check and urine drug screen (medical marijuana cards approved)
  • Previous quality experience and/or active participation in the accreditation process (2-3 years),
  • Previous experience in utilization or case management programs (2-3 years) with a good understanding of healthcare program delivery.
  • Previous experience with the Cigna medical complex or specialty case management program
  • Demonstrated ability to effectively manage large scope projects
  • Ability to communicate effectively, both oral and written, with various levels of the organization
  • Ability to handle multiple, complex, and competing priorities and projects under pressure.
  • Ability to manage in a highly matrixed environment
  • Ability to influence change
  • Ability to learn on the fly and work independently in a fast pace environment
  • Ability to influence change
Company Description
We are still hiring during the pandemic of COVID-19 (or CoronaVirus). Your health and safety is our #1 priority at Tailored Management. We will be conducting phone/video interviews during this time to ensure your safety.
Estimated annual salary
$82,874
average
Minimum
$61,358
Maximum
$116,255

TASKS

  • Maintain accurate, detailed reports and records.
  • Administer medications to patients and monitor patients for reactions or side effects.
  • Record patients' medical information and vital signs.
  • Monitor, record, and report symptoms or changes in patients' conditions.

SKILLS

  • Reading ComprehensionUnderstanding written sentences and paragraphs in work related documents.
  • Active ListeningGiving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • WritingCommunicating effectively in writing as appropriate for the needs of the audience.
  • SpeakingTalking to others to convey information effectively.

KNOWLEDGE

  • Customer and Personal ServiceKnowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
  • Computers and ElectronicsKnowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
  • MathematicsKnowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
  • BiologyKnowledge of plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment.

Tailored Management

Type

Company - Private

Size

Small

Revenue

$5M to $10M

Location

Traverse City, MI,

Industry

Human Resources

Founded

1968

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