Our Healthcare Insurance client is seeking a Episodic Care Manager to join their team for a contract role!
Our client has more than 5,000 employees and is the number 1 health insurer in the state of North Carolina serving more than 3.89 million customers.
Health care is changing, and our client is leading the way by provide innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs. Our client is a not-for-profit with headquarters in Durham, NC.
Position: Episodic Care Manager
Term: 3 months
Day-to-Day Responsibilities: This is a Behavioral Health ECM. 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
Is this a good fit? (Requirements):
- RN preferred, LPN - but Candidates "MUST" have critical care/clinical experience, working in a hospital on the floor experience, hands on.
- They must have broad clinical experience.
- Prior insurance experience
- Must have NC Licensure
- Required: Behavioral experience hospital, outpatient, ER/emergency clinical experience.
Hours: 8-5 Monday- Through Friday, with alternating weekends 8-3 on Sat and 8-12 on Sunday. Aprox. 2-3 weekends per quarter and time would be given back during the week so no overtime will be required.