Psychiatric RN Case Manager - Field - BH
Posted on: 2 Feb 2021
Middleburg, FL
Job Description
Position Purpose:
* Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care
* Develop, assess and adjust, as necessary, the care plan and promote desired outcome
* Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
* Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
* Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
* Provide patient and provider education
* Facilitate member access to community based services
* Monitor referrals made to community based organizations, medical care and other services to support the members overall care management plan
* Actively participate in integrated team care management rounds
* Identify related risk management quality concerns and report these scenarios to the appropriate resources
* Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
* For LTSS - 30% travel to perform home visits to members
* For New Hampshire, Massachusetts, & Michigan Complete Health - home visits required
Education/Experience:
Graduate from an Accredited School of Nursing. Bachelors degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting. Knowledge of healthcare and managed care preferred.
Licenses/Certifications: Current states RN license.
Preferred:
Strong preference for residence in the following Florida Counties: Clay or Duval County.
Prior professional experience in behavioral health or mental health settings.
title:Psychiatric RN Case Manager - Field - BH
WellCare
Tampa, FL
WellCare Health Plans, Inc. provides government-sponsored managed care services. The company operates in three segments: Medicaid Health Plans, Medicare Health Plans, and Medicare Prescription Drug Plans (PDPs). The Medicaid Health Plans segment offers plans for beneficiaries of temporary assistance for needy families, supplemental security income, and aged blind and disabled residents; and other state-based programs, such as children's health insurance programs and long-term services and supports programs for qualifying families who are not eligible for Medicaid.
The Medicare Health Plans segment provides Medicare, a federal program that provides eligible persons aged 65 and over, as well as some disabled persons with a range of hospital, medical, and prescription drug benefits; Medicare Advantage, a Medicare’s managed care alternative to the original Medicare program, which offers individuals standard Medicare benefits directly through Centers for Medicare & Medicaid Services; and coordinated care plans that are administered through health maintenance organizations and require members to seek health care services and select a primary care physician from a network of health care providers.
The Medicare PDPs segment provides Medicare part D PDP plans to Medicare-eligible beneficiaries. Its PDP plans offer national in-network prescription drug coverage, including a preferred pharmacy network. As of December 31, 2018, the company served approximately 5.5 million members in the United States. WellCare Health Plans, Inc. was founded in 1985 and is headquartered in Tampa, Florida.
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IndustryHealthcare
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No. of Employees12, 000
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Website
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Jobs Posted917
