Case Manager

Company: The Judge Group
Location: Dayton
Posted on: June 24, 2022

Job Description:

Location: Dayton, OH Description: Judge Healthcare is looking of a Case Manger in OH!Must live in: Hamilton, Clermont, Butler, Warren, Clinton, Montgomery, Greene or Clark County. - -Hours: -Mon-Fri, 8a-5p EST -The Judge Group is looking for a Case Manager to be responsible for health care management and coordination for members to achieve clinical, financial, and quality of life outcomes.**Must be willing to follow vaccine mandate and visit members in homes/hospital/nursing facility**Essential Functions:

• Conduct face to face or home visits as required.
• Provide case management services to members with chronic or complex conditions including:
• Identifies members that may qualify for potential case management services.
• Conduct assessment of member needs by collecting in-depth information from our information system, the member, member's family/caregiver, hospital staff, physicians, and other providers.
• Develop and implement a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.
• Perform ongoing monitoring of the plan of care to evaluate effectiveness.
• Measure the effectiveness of interventions to determine case management outcomes.
• Promote integration of services for members including behavioral health and long-term care to enhance the continuity of care. -Knowledge/Skills/Abilities:
  • Knowledge of applicable state, and federal regulations.
  • Knowledge of ICD-9, CPT coding and HCPC.
  • SSI, Coordination of benefits, and Third-Party Liability programs and integration.
  • Familiarity with NCQA standards, state/federal regulations, and measurement techniques.
  • In depth knowledge of CCA and/or other Case Management tools.
  • Computer skills and experience with Microsoft Office Products. -Required:
    • Bachelor's degree in Nursing or master's degree in social work, or Health Education (a combination of experience and education will be considered in lieu of degree).
    • 0-2 years of clinical experience with case management experience.
    • Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing.
    • A combination of experience and education will be considered in lieu of LCSW or APSW.
    • Valid driver's license with good driving record and be able to drive locally. -If this sounds like an opportunity you would be interested in, please send your updated resume to -chead@judge.com
      Contact: This job and many more are available through The Judge Group. Find us on the web at

Keywords: The Judge Group, Dayton , Case Manager, Executive , Dayton, Ohio