Case Management Senior
Aerotek – Rancho Cordova, CA – FEP Care Management Nurse: Determines, develops and implements a plan of care based on accurate and comprehensive assessment of the member’s needs. Applies detailed knowledge of FEP PPO and Company established medical/departmental policies, clinical practice guidelines, community resources, contracting and community care standards to each case. Works with complex cases, promotes the delivery of quality; cost-effective health care services based on medical necessity and contractual benefits. Provides guidance to the provider network. Performs effective discharge planning and collaborates with member support system and health care professionals involved in the continuum of care. Coordinates Care for Lower Level of Care coordination such as Skilled Nursing Facility, Home Health, Home Infusion, Rehab. Makes referrals to Quality Management, Catastrophic Case Management and Appeals and Grievance Department. About Aerotek: We know that a company’s success starts with its employees… – Permanent – Full-timeApply for this job.