Case Management Specialist - Field

Conseco is a leading provider of supplemental health insurance, life insurance and annuities for middle income Americans - throughout their working careers and beyond. Through its subsidiaries and a nationwide network of distributors, Conseco serves more than 4 million customers.

Conseco was founded in 1979, began operations in 1982, and became a public company in 1985. Conseco joined the Fortune 500 (Fortune magazine's listing of America's largest public companies, ranked by revenue) in 1996. Conseco's principal operations include: Conseco Insurance Group and 40/86 Advisors, based in Carmel, Indiana; Bankers Life and Casualty Company in Chicago, Illinois; Colonial Penn Life Insurance Company in Philadelphia, Pennsylvania; and Performance Matters Associates (PMA) in Dallas, Texas.

--Manage cases of policyholders to determine appropriate services by reviewing assessments prepared by FCS or outside vendors.
--Develop effective Plans of Care based on PH needs and plan benefits to assure quality of care.
--Review and evaluate completed assessments and other PH medical records.
--Determine most appropriate services to assure quality of care for policyholder care needs
--Develop an effective Plan of Care based on the policyholders needs and LTC benefits, involving available support systems and interdisciplinary collaboration.
--Collaborate with LTC Claims Legal support and Medical Director as needed.
--Communicate and obtain approval for Plans of Care from PH physician
--Document effectiveness of case management services, Plans of Care, contacts with PH, family, and providers in appropriate systems
--Implement the Plan of Care.
--Monitor the status of the policyholder on an on-going basis as required per policy.
--Modify Plans of Care as needed.
--Store PH files in secure location to ensure patient, client and provider confidentiality
--Perform other essential duties as assigned.

Requirements:

--Active Florida RN license in good standing.
--BSN preferred.
--Must have at least three years of clinical experience, Long Term Care or Rehabilitation experience preferred
--Experience in case management principles, professional practice standards, life and health insurance industry knowledge, consumer healthcare issues, and current trends in healthcare.
--A proven work history with direct patient-care interaction.
--Certified Case Manager (CCM) certification preferred
--Knowledge of healthcare and treatment options, ICD-9 and CPT coding methodology
--Strong analytical abilities along with the ability to prioritize
--Knowledge of Microsoft Word, Excel, and Outlook
--Proven abilities in assessment, planning, implementation, evaluation, and documentation relevant to industry standard in case management

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