*Nurse Case Manager II

  • Sector: MRS Nursing
  • Contact: Marie Nellas
  • Duration: 6 months
  • Start Date: 12/05/22
  • Client: Medical Recruitment Strategies
  • Location: Cincinnati, United States of America
  • Salary: Negotiable
  • Expiry Date: 19 February 2023
  • Job Ref: BBBH408462_1669061014
  • Contact Email: mnellas@medicalrecruitmentstrategies.com

Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services

Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate
administration of benefits

Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures