Job Description

Our Client, a Retail Pharmacy company, is looking for a Nurse Case Manager II - Michigan for their Berrien County MI, Van Buren County MI, Cass County MI, Kalamazoo County MI, St. Joseph County MI, Calhoun County MI, Branch County MI, Jackson County MI, Hillsdale County MI, Livingston County MI, Washtenaw County MI, Lenawee County MI, Monroe County MI, Oakland County MI, Macomb County MI, Wayne County MI, Clinton County MI, Eaton County MI, or Ingham County MI location.
Responsibilities:

• The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
• 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

Requirements:

• Verifyable High School Diploma or GED Required
• 3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
• Healthcare and/or managed care industry experience.
• Case Management experience preferred
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
• Maternity and NICU experience preferred
• Effective communication skills, both verbal and written.
• Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
• Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
• Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
• Typical office working environment with productivity and quality expectations
• Case Management Certification CCM preferred
• RN with current unrestricted state licensure in the state of MI.

Why Should You Apply?

• Excellent growth and advancement opportunities

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, gender, sexual orientation, gender identity or express, ethnicity, national origin, age, disability status, political affiliation, genetics, marital status, protected veteran status, or any other characteristic protected by federal, state, or local laws.

Skills Required