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1 job found in madison, new jersey

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    • ho-ho-kus, new jersey
    • contract
    Top national managed care organization looking for Field Case Management Coordinator in , IL! Great opportunity, please call us today! Duties: Evaluation of Members:-Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.- Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives? presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.- Identifies and escalates quality of care issues through established channels.- Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.- Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.-Provides coaching, information and support to empower the member to makeongoing independent medical and/or healthy lifestyle choices.-Helps member actively and knowledgably participate with their provider in healthcare decision-making. Monitoring, Evaluation and Documentation of Care:- Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Qualifications: Bachelor's degree REQUIRED or non-licensed master-level clinician, with degree being in behavioral health or human services (psychology, social work, marriage and family therapy, nursing, counseling, etc.) Shift: Monday-Friday 8am-5pm CSTEqual Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.
    Top national managed care organization looking for Field Case Management Coordinator in , IL! Great opportunity, please call us today! Duties: Evaluation of Members:-Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.- Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care:- Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives? presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.- Identifies and escalates quality of care issues through established channels.- Utilizes negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs.- Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.-Provides coaching, information and support to empower the member to makeongoing independent medical and/or healthy lifestyle choices.-Helps member actively and knowledgably participate with their provider in healthcare decision-making. Monitoring, Evaluation and Documentation of Care:- Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Qualifications: Bachelor's degree REQUIRED or non-licensed master-level clinician, with degree being in behavioral health or human services (psychology, social work, marriage and family therapy, nursing, counseling, etc.) Shift: Monday-Friday 8am-5pm CSTEqual Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status. For certain assignments, Covid-19 vaccination and/or testing may be required by Randstad's client or applicable federal mandate, subject to approved medical or religious accommodations. Carefully review the job posting for details on vaccine/testing requirements or ask your Randstad representative for more information.

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