NEW Postings:

Select Specialty Hospital - Durham

Lead Case Manager - Full Time

The Lead Case Manager assumes responsibility for the overall functions and professional growth of the Department by contributing to Facility Policies and programs, fiscal management and payor/referral satisfaction. This position is responsible for documentation compliance for regulations governing Utilization Review and Discharge Planning. A Registered Nurse is preferred with other health care professions considered with at least three (3) years of work experience in a medical case management setting. A working knowledge of the insurance industry, government reimbursement, progression of care management and discharge planning skills are required.

Contact Person: Catherine Gadzouris
Email Address: cgadzouris@selectmedical.com
Phone: 919-470-9011
Fax: 919-470-9021

http://www.selectspecialtyhospital.com/

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Key Risk is an insurance company and provides TPA services in workers compensation. We currently are interviewing for positions:

Onsite Medical Case Manager RN
Full time with benefits
Home office based but attends physician appointments with injured worker

Utilization Review RN
Full time with benefits
Company Office based-Greensboro or Columbia office

***To apply for this position please submit your application online at http://www.bcbsnc.com/careers/ and do a keyword search for position number 9133***

Team Lead, Medical (Case Mangement/RN)

Major Responsibilities:
Manages day-to-day business area activities, provides leadership/direction to team members, and sets expectations. Acts as a technical resource for team members providing assistance/guidance on system issues, benefits, and work processes and procedures. Creates a positive work environment that fosters teamwork, empowerment, accountability, and ownership.

Requirements:

• RN, PA, or FNP degree with valid NC license.
• 3 years previous clinical nursing experience, or 3 years in a health insurance industry such as Utilization Management processes, managing health conditions, understanding medical criteria, medical guidelines, medical policy, and NCQA and DOI, Medicare/CMS regulations.
• Knowledge of Windows and Microsoft Office required.
• Certified Case Manager (CCM) certification is required within 2 years of obtaining the role of Team Lead.

***To apply for this position please submit your application online at http://www.bcbsnc.com/careers/ and do a keyword search for position number 9123***

Episodic Care Manager

Major Responsibilities:
The Episodic Care Manager is responsible for performing medical reviews to assess, facilitate, and coordinate the delivery of care across the Health Care System. The Episodic Care Manager acts as a member advocate to promote and coordinate the delivery of quality, cost effective health care services based on medical necessity and contractual benefits. In addition, the Episodic Care Manager coordinates with providers and consumers to support the delivery of high quality care across the health care system.

Requirements:

• RN, LPN, PA, or FNP degree with valid NC license.
• For RN, PA, or FNP, 3 years previous clinical nursing experience, preferably in a variety of clinical settings, or 2 years in a health insurance related industry such as Utilization Management processes, managing health conditions, understanding medical criteria, medical guidelines, medical policy, and NCQA and DOI regulations.
• If LPN, 5 years previous clinical nursing experience preferably in a variety of clinical settings, or 4 years in a health insurance related industry such as Utilization Management processes, managing health conditions, understanding medical criteria, medical guidelines, medical policy, and NCQA and DOI regulations.
• Knowledge of Windows and Microsoft Office required.

***To apply for this position please submit your application online at http://www.bcbsnc.com/careers/ and do a keyword search for position number 9132***

Case Manager

Major Responsibilities: The Case Manager coordinates the care and services of selected member populations across the continuum of care, promotes effective utilization and monitoring of health care resources, and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resource outcomes.

Requirements:

• RN Diploma, RN Associate's degree or Bachelor's of Science in Nursing (BSN) degree.
• Minimum of 3 years clinical experience in an acute medical or acute surgical setting.
• Proficiency with a Microsoft Windows operating system.
• Must have valid license to practice nursing within the US and have started application for NC nursing license.
• Within four (4) years of hire as a case manager, it is required that the case manager will possess a URAC-recognized certification in case management.

Our firm, The Gammill Group, is currently partnered with Rex Hospital to assist in their search for a Director of Case Management.

Located in Raleigh North Carolina, Rex Hospital is a Magnet designated 541 bed, not for profit hospital that excels at providing excellent patient care.

JOB DESCRIPTION

.Please contact:

Trinity M. Cody

Executive Recruiter
The Gammill Group
614-848-7726
www.gammillgroup.com

tcody@gammillgroup.com

The sites listed below are national job search engines for Case Managers and Social Workers.

http://www.healthcarescouts.com

http://www.rncasemanager.com/

http://www.nursejobshop.com/search.cfm

http://www.healthcaresource.com/findajob.cfm