RN Case Manager-Medicare

Medical Mutual of Ohio - Cleveland, OH4.0

29 days agoFull-timeEstimated: $65,000 - $87,000 a year
EducationSkillsBenefits
Engages members in the case management process. Plans, implements, coordinates, monitors and evaluates the treatment options of health care services. Coordinates the delivery of services and addresses physical/psychological factors involved in planning the patient's care and will assist with the setting of member specific goals that are geared towards the promotion of quality, cost effective outcomes.

Responsibilities:
  • Collaborates with clients, families and providers by assessing patient needs, facilitating and implementing clinical care, planning, education, monitoring and evaluating specific services and advocating healthcare needs on an individual basis either by phone and/or by on site visits.
  • Utilizes clinical expertise and standards of practice in determining appropriate treatment options
  • Applies knowledge of disease continuums, expected patient outcomes and community services available.
  • Applies knowledge of reimbursement practices, cost analysis approaches and provider contract arrangements.
Qualifications

  • Bachelor’s degree in a health related field
  • 3 years of clinical experience in an acute care setting
  • Certified Case Manager (CCM) preferred.
  • Active Licensure as a Registered Nurse in the State of Ohio
  • Minimum of 2 years Medicare experience required
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:
  • Top Workplace in Northeast Ohio. Year after Year we've received this recognition!
  • On-site wellness center at most locations. Enjoy personal trainers, towel service, locker room, weight room, elliptical machines, and a variety of classes!
  • On-site cafeteria serving hot breakfast and lunch, at most locations. Choices ranging from salad bar, made to order, hot and cold sandwiches, or a variety of entrees cooked fresh daily. Convenience store at most locations
  • Employee discount program. Discounts at many places in and around town, just for being a Medical Mutual team member
  • Business casual attire Excellent Benefits and Compensation:
  • Competitive compensation plans
  • Employee bonus program
  • 401(k) with company match and an additional company contribution
  • Excellent medical, dental, vision, and disability insurance
An Investment in You:
  • Career development programs and classes
  • Mentoring and coaching to help you advance
  • Education reimbursement up to $5K per year
About Medical Mutual:
We strive to create peace of mind. Our customers can trust us to do things right and to help them get value from their health plan. We're the largest health insurer in Ohio and for over 80 years, we've been serving our members and the Ohio communities where they live and work. Medical Mutual is a Top Place to Work in Northeast Ohio with exceptional career opportunities that offer challenge, growth and a great work/life balance. We want talented, innovative, and driven people to help us continue to be the best health insurance choice of Ohioans and help make Ohio the best it can be! Our headquarter building is located in the heart of downtown Cleveland and we have multiple offices throughout the state. Join us at one near you!

At Medical Mutual we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.

Primary Location: US-OH-Cleveland
Other Locations: US-OH-Strongsville
Work Locations: Cleveland - Headquarters 2060 East Ninth Street Cleveland 44115
Job: 7 - General Staff
Organization: Managed Care
Schedule: Regular
Shift: Standard
Employee Status: Individual Contributor
Job Type: Full-time
Job Level: Day Job
Job Posting: Oct 18, 2018, 8:01:55 AM