Case Manager RN - OB Job
Location: Hanover Maryland
Description: Amerigroup is presently looking of Case Manager RN - OB Job right now, this position will be placed in Maryland. For detail informations about this position opportunity kindly see the descriptions. Case Manager RN - OB
Job ID 2013-23902 # Positions 1
Location US-MD-Hanover
Search Category Nursing
Type Regular Full-Time (30+ hours) Posted Date 8/28/2013
Additional Locati! ons ..
More information about this job:Summary:
Responsible for managing members experiencing complex or catastrophic illness, high risk pregnancy, injury and/or specialty illnesses such as diabetes, HIV, transplant, behavioral health conditions, etc., to ensure cost effective and efficient utilization of health services. Conducts continuous skills assessment, planning, implementation, coordination, monitoring and evaluation.
OB experience required and prior Case Management experience strongly preferred.
Bilingual (English/Spanish) skills desired.
Responsibilities:
1. Obtains an accurate member history, conducts an assessment of biopsychosocial factors, and assesses clinical information to develop care plans including a member support system.
2. Establishes prioritized short and long term goals in collaboration with the member that meet the member’s needs and the referral source’s requirements.
3. Establishes working relationships with referral sour! ces and community resources.
4. Identifies members with potential for high risk complications and coordinates the appropriate treatment in conjunction with the member and the health care team.
5. Collaborates with the member’s PCP and specialists in the development of the plan of care to ensure that members’ physical needs are addressed; communicates care objectives to appropriate individuals/departments/referral sources.
6. Provide case management and/or disease management services to members, as identified by a health plan’s referral process.
7. May be required to conduct field visits.
8. May be required to perform service authorization duties using prescribed criteria and responsibilities as assigned and required by the Plan.
9. Acts as an advocate for an individual’s health care needs.
10. Reviews benefit systems and cost benefit analysis; evaluates the quality and necessity of applicable services; i! dentifies members that would benefit from an alternative level of care; acquires data and evaluates necessary health services for cost containment; documents effectiveness of case management services.
11. Participates in Quality Improvement processes and serves on internal and external committees as required.
12. Other duties as requested or assigned.
Qualifications:
EDUCATION AND EXPERIENCE
Education
Required:
Preferred:
Years and Type of Experience Required:
Required:
Preferred:
Certifications or Licensures
Required:
Preferred:
Language Skills
Required:
Preferred:
Functional Competencies
PHYSICAL REQUIREMENTS
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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If you were eligible to this position, please email us your resume, with salary requirements and a resume to Amerigroup.
If you interested on this position just click on the Apply button, you will be redirected to the official website
This position starts available on: Thu, 29 Aug 2013 01:23:49 GMT