Cleveland Clinic Case-Manager-Employee-Health-Plan in Independence, Ohio

Job Summary:

Manages cost-effective, quality patient outcomes by collaborating with staff and providing guidance, education and support to assigned clients. Collaborates and consults with multidisciplinary team regarding clients progress and performs continuous assessments, evaluations to monitor client's progress.

Prefer 5 years of acute care nursing experience.

Responsibilities:

  • Collaborates and consults with multidisciplinary team regarding clients' progress and performs continuous assessments and evaluations to monitor client's progress via electronic methods.

  • Contacts recently discharged members via telephone per department protocol and interacts with all callers in a professional and courteous manner and follows established guidelines and document all interactions via EMR.

  • Works with interdisciplinary team and administration to monitor client, family payer's satisfaction via electronic methods.

  • Evaluates all relevant data and obtains information while carefully considering the facts surrounding the case.

  • Assists with the implementation of a comprehensive program of utilization management to support all provided healthcare services.

  • Other duties as assigned.

Education:

  • Graduate from accredited school of Nursing or Behavioral Health Science.

Certifications:

  • Current state licensure as an Registered Nurse (RN) or Licensed Professional Clinical Counselor (LPCC), Licensed Independent Social Worker (LISW).

  • Certified Case Manager (CCM) preferred.

Work Experience:

  • Minimum one year of experience in a managed care setting, previous work with network providers, and a minimum of five years clinical experience.

Physical Requirements:

  • Manual dexterity to operate office equipment.

  • May require extended periods of sitting. Good visual acuity through normal or corrected vision and good audio acuity.

The policy of Cleveland Clinic and its system hospitals (Cleveland Clinic) is to provide equal opportunity to all of our employees and applicants for employment in our tobacco free and drug free environment. All offers of employment are followed by testing for controlled substance and nicotine. Job offers will be rescinded for candidates for employment who test positive for nicotine. Candidates for employment who are impacted by Cleveland Clinic’s Smoking Policy will be permitted to reapply for open positions after 90 days. Decisions concerning employment, transfers and promotions are made upon the basis of the best qualified candidate without regard to color, race, religion, national origin, age, sex, sexual orientation, marital status, ancestry, status as a disabled or Vietnam era veteran or any other characteristic protected by law. Information provided on this application may be shared with any Cleveland Clinic facility.

Cleveland Clinic is pleased to be an equal employment employer: Women/Minorities/Veterans/Individuals with Disabilities