JOB REQUIREMENTS: Overview RN Case Management Coordinator, MercyCareInsurance, Days, 80 Hrs/2 wks Location: MercyCare Bldg, Janesville, WICase Management activities will be supervised by a Certified CaseManager (CCM) until CCM successfully obtained. Responsible forperforming highly detailed complex case management (CM) activities forindividual plan members. Able to perform a screening to determine ifmember has the potential to meet criteria for a full assessment andenrollment into Complex Case Management. Responsible for independentlyperforming a complete assessment for the purpose of developing anIndividualized Care Plan that address identified objectives and goals.Able to identify key team members for participation on individualmember\'s Interdisciplinary Care Team. Appropriately uses metric toolsto provide measurements on progress. Appropriately identifiesevidence-based guidelines that should be followed for each individualcomplex case management participant. May also be responsible forcoordinating and monitoring quality initiative and reviews including butnot limited to, focus studies, clinical guidelines and preventativehealth guidelines. Attends and contributes as required to Health Plancommittees such as Quality Taskforce and others assigned.Responsibilities Will spend no less than seventy-five percent of timeproviding direct case management activities on the phone, face to face,e-mail or other interactive methods Collects and assesses in depthinformation about a person\'s situation and functions to identifyindividual needs in order to develop a comprehensive individualized caremanagement plan that will address those needs, meet goals and improvehealth outcomes Determines specific objectives, goals and actionsdesigned to meet the clients\' needs as identified through theassessment process; determines benefits/coverage of medical necessitybased on MercyCare\'s medical certificate of coverage Executes specificcase management activities and or interventions that will lead toaccomplishing the goals set forth in the case management plan.Organizes, integrates and modifies the resources necessary to accomplishthe goals set forth in the case management plan. Monitors the ongoingprocess by gathering sufficient information from all relevant sourcesabout the case management plan and its activities and determine theplans effectiveness. Evaluates case managements effectiveness inreaching desired outcomes and goal and makes modifications or changes inthe case management plan based on the evaluation. Participates aseducator and resource person for provider offices and hospital staff asit pertains to the health plan case management policy and procedures.Will spend no more than Twenty-five percent of time coordinating andmonitoring non direct case management... For full info followapplication link. EOE&AA/M/F/Vet/Disabled. Mercy is an equal employmentopportunity employer functioning under Affirmative Action Plans.***** APPLICATION INSTRUCTIONS: Apply Online:ipc.us/t/34D46D702F9547DB