Case Manager, Complex
Case Manager, Complex Requisition #: 176606 Location: Johns Hopkins Health Care, Baltimore, MD Category: Nursing Work Shift: Day Shift Work Week: Full Time (40 hours) Weekend Work Required: No Date Posted: Oct. 28, 2018 Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field. The Case Manager anticipates and coordinates care / services / health education for targeted member populations with chronic disease conditions or high cost specialty care. This individual must demonstrate knowledge of complex case management, prognosis and outcomes, and is responsible for ensuring that member goals are achieved within a specified time period based upon individual needs, reasonable expectations and well-documented outcomes. Requirements: Bachelor's Degree from an accredited school of nursing/related field; or RN currently enrolled in a bachelors program with a documented plan for completion; Master's Degree in Social Work is also accepted Minimum five (5) years clinical practice Three (3) years case management; Managed care experience preferred Current registered nurse licensure in the state of Maryland or LCSW-C Certification in case management (CCM) preferred Demonstrated clinical expertise Knowledge of health care and managed care delivery systems. Experience with insurance benefit structures and related legal/ medical issues Understanding of utilization management and quality improvement processes Ability to work in a dynamic, team-oriented environment and demonstrate positive relationship building Effective verbal/ written communication Ability to perform critical analysis, plan and organize effectively Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law. Company Description: Established in 1995, Johns Hopkins HealthCare (JHHC) is the health insurance division of Johns Hopkins Medicine, and a critical partner in the Hopkins' tripartite mission of patient care, education and research. JHHC is driven by a member-centered strategy to provide excellent service, improve health and reduce costs. And through data-driven analytics and innovative approaches, JHHC assures that all 400,000 plan members receive efficient and effective coordinated care.