Careers

Search Jobs Connect With Us

Case Management Nurse

Job Attributes

Job Id:

19805

Job Category:

Clinical & Life Sciences

Job Location:

Durham, NC  27701

Security Clearance:

No Clearance

Business Unit:

Piper Companies

JOB DESCRIPTION

Piper Clinical Solutions is seeking a driven Case Management Nurse in Durham, NC to support a Health Insurance Company with case management activities for members across multiple providers and medical service lines.

 

Responsibilities for the Case Management Nurse:

  • Perform assessments of assigned patients to determine health status, patient medical knowledge, and level of service
  • Analyze specific patient condition issues, patient medical history, issued medications, mental health status, cognitive function, and patient lifestyle to identify specific goals for the patient to obtain throughout the length of care
  • Develop short and long-term care plans for each patient
  • Identify and educate patient on any barriers to meet care plan goals or compliance issues that may arise throughout the care plan
  • Monitor and manage patient through scheduled follow-up’s, discussion of plan, appropriate services education, referrals, and assessment of progress
  • Evaluate and facilitate care provided to patients as they progress through continuum of care
  • Modify patient plans and goals as needed through outreach with a minimum of every 30 days and complete documentation of calls appropriately  
  • Review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options
  • Identify high risk, high cost, or high utilization cases and educate patients on effective pro-active intervention to encourage positive outcomes
  • Collaborate with primary care physicians, Medical Care Coordinators, Discharge Planning, and Medical Director

Responsibilities for the Case Management Nurse:

  • 3+ Years of Acute Care Nursing Experience
  • Active North Carolina Registered Nursing License (RN)
  • Associate’s Degree OR Bachelor’s Degree in Nursing

Responsibilities for the Case Management Nurse:

  • Salary up to $83,000 based on meeting of requirements
  • Benefits: Health, Dental & Vision Insurance, 401K Contributions & Life Insurance

 

Please send all qualified resumes to: idusci@pipercompanies.com

 

Keywords

Utilization review, registered nurse, milliman, interqual, pre-pay, acute care, health insurance, health plan, health care, medical review, nurse, manager, intake, outpatient, medical review, home care, RN, CCM, Certified case manager, case management, medicare, medicaid, advance med, aerial, cms, tri care, healthsuite, advantage md, ushfp, ehp, priority partners, hospital, discharge planning, NCDOI, NCQA, Federal, care management, case management

 

Apply Now

CONTACT INFORMATION (Required)
RESUME (Required)
No file selected
x
Formats accepted: .doc / .docx / .pdf / .txt
Don't have a resume? Click here to fill out a short form.

Copy/paste your resume inside the text editor below:

ADDITIONAL INFORMATION (Required)
WORK HISTORY (Required)
Add another experience (optional)
EDUCATION (Required)
Add another degree (optional)
SKILLS (Required)
Add another skill (optional)

The following error(s) occurred:

Please wait while your job application is being processed. This may take a few moments.
New Search

Job Id:

19805

Job Category:

Clinical & Life Sciences

Job Location:

Durham, NC  27701

Security Clearance:

No Clearance

Business Unit:

Piper Companies