Nurse Case Manager II SW Michigan

Adecco is currently assisting a National Pharmaceutical client, recruiting for a Case Manager II with a unrestrictive RN License.

Must have an RN - unrestricted and active in state of Michigan

Schedule : Mon-Fri 8am - 5pm EST

Candidates should be either in one of these counties or very close to it. They will be traveling to this region. Sourcing for SW Michigan (Counties : Barry, Van Buren, Kalamazoo, Calhoun, Branch, St Joseph, Cass, and Berrien Counties)

The anticipated wage for this position is $46.66. Hourly wage may depend upon experience, education, geographic location and other factors.

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. Requires an LMSW or LCP with unrestricted active license

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

Assessment of Members :

• Through the use of clinical tools and information / data review, conducts comprehensive assessments of referred members needs / eligibility and determines approach to case resolution and / or meeting needs by evaluating members benefit plan and available internal and external programs / services.
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues.
• Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated.
• Provides crisis follow up to members to help ensure they are receiving the appropriate treatment / services.

Enhancement of Medical Appropriateness and Quality of Care :

Monitoring, Evaluation and Documentation of Care :

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Benefit offerings include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and 401K plan. Our program provides employees the flexibility to choose the type of coverage that meets their individual needs. Available paid leave may include Paid Sick Leave, where required by law; any other paid leave required by Federal, State, or local law; and Holiday pay upon meeting eligibility criteria.

Pay Details : $46.66 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer / Veterans / Disabled

Military connected talent encouraged to apply

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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and / or security clearance requirements, including, as applicable :

Massachusetts Candidates Only : It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.