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The Complex Case Manager works within the framework of multiple products to establish collaborative processes that promote quality and cost effective care. Case Management activities require interfacing with members, providers, clinics, medical directors, intake staff, and other departments within. Performance is primarily measured by quality audits, regulatory requirements, and meeting case-management industry benchmarks.
Education Level: Bachelor’s Degree in nursing – preferred or equivalent nursing experience.
Years of experience required: 5 years case management, utilization management or hospital care coordination experience.
Specific types of experience required:
-Certified Case Manager (CCM) preferred
-Managed care experience preferred
-Minimum 5 years of clinical/acute care experience
General working knowledge of how various health care services link together (the health care continuum).
Experience working with multiple age groups, medical, surgical background and a generalized level of understanding across specialty care areas.
Accomplished in communication with physicians and health care providers.
Excellent internal and external customer service skills, strong decision making skills.
Ability to think creatively and be comfortable negotiating and accessing resources.
Excellent verbal and written skills and the ability to present in a group setting.
Experience managing multiple computer systems and tools.
Ability to work independently in a fluid, ever-changing environment.
Ability to thrive in fast-paced setting and make decisions under stress and manage multiple complex issues on a daily basis.
Top Talent Solutions offers immediate placements for temporary, temp-to-hire and direct hire positions in all industries – from light industrial to administrative, and everything in between. But, we go a step further to offer you the personal touch that’s missing from so many other employment firms. Locally owned and operated, with multiple locations throughout Minneapolis and St. Paul, Top Talent Solutions works with nearly 1000 of the top companies in the region – from small businesses to national corporations. Our vast network allows us to build the strategic partnerships that, ultimately, you will benefit from.
Top Talent Solutions is in Equal Opportunity and Drug Free Employer