Case Manager
Case Manager
Posted on :
13-10-2024
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Job Description
Job Title: Case Manager
Location: Fully Remote
Duration: 3 Months Temp to Perm
Shift: 1st Shift Monday to Friday
Job Summary
- The Case Manager provides comprehensive case management services to TRICARE beneficiaries. This role involves screening referrals conducting assessments developing individualized care plans and monitoring outcomes. The Case Manager ensures compliance with HIPAA regulations URAC standards and TRICARE policies while advocating for beneficiary access to necessary care.
Key Responsibilities:
- Case Management: Screen referrals and perform comprehensive assessments. Develop and implement individualized care plans reassess monthly and adjust as needed.
- Compliance & Reporting: Ensure compliance with HIPAA URAC standards and TRICARE policies. Document case management processes and outcomes.
- Beneficiary Advocacy: Facilitate access to specialized services provide TRICARE and community resource information and support care plan goals.
- Communication: Collaborate with Primary Care Managers or Behavioral Health providers. Present highprofile cases to the Medical Director as needed.
- Supervision: Provide directions to nonclinical staff.
Required Qualifications:
- Licensure: Current unrestricted state license as a Licensed Clinical Social Worker Registered Nurse or Clinical Psychologist.
- Experience: Minimum of 2 years of fulltime direct clinical care experience.
- Certification: Ability to obtain a URACrecognized certification in case management within 4 years of hire.
- Background Check: Must pass a Department of Defense (DOD) background investigation.
- Citizenship: U.S. Citizenship required.
Preferred Qualifications:
- 2 years of case management experience.
- URACrecognized case manager certification.
Competencies:
- Technical Skills: Proficiency in Case Management TRICARE policies HIPAA URAC standards and medical management systems. Familiarity with InterQual ISD criteria and medical coding.
- Problem Solving: Ability to analyze issues systematically and propose practical solutions.
- Organizational Skills: Expertise in task coordination time management and adjust to changing priorities.
- Communication: Strong people skills with the ability to influence listen and adapt communication styles effectively.
- Computer Literacy: Proficient in Microsoft Word Outlook and departmentalspecific software.
Additional Details:
- Geographic Hiring: Roles are available across T5 territory covering twentysix states. Candidates are primarily sought from CSTPST time zones. CST candidates must be available to work 9:30 AM 6:00 PM.
- Candidates in Alaska and Hawaii are also encouraged to apply. Exceptional candidates from EST may be considered if they can work 10:00 AM 6:30 PM.
Working Conditions:
- Standard office environment with minimal travel required.
- Extensive computer uses with long periods of sitting.
- Availability to cover any work shift.
- Department of Defense security clearance required.
Employment Type
Full Time
Key Skills
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