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Nurse Rev II - Case Management (Home Based with Client Visits)
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Work from home
- Under the general supervision of the Associate Director, or designee, the Nurse Reviewer II is responsible for providing administrative case management as part of the Community Case Management Program.
- As a member of a multidisciplinary team, the Nurse Reviewer II is responsible for assessing, planning, organizing, reviewing and evaluating the care needs of Members requiring community based services.
- Contribute as an active member of a multi/inter-disciplinary team to assess, plan, organize, review and evaluate the care needs of Members requiring health care services, to include outpatient and home based therapy services.
- Conduct on-site reviews and assessments of Member's community long term care needs to determine medical necessity and clinical eligibility for Community Case Management and Continuous Skilled Nursing Services Determine and authorize services for Members in accordance with program guidelines and regulations.
- Foster and promote continuity of care and cooperative partnerships by liaising with health care providers, acute care hospitals and other programs/organizations involved in the provision of services.
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