Case Manager RN Cover Letter

Please consider me for the case manager RN opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for feedback to Division Case Management Director on issues related to department operations: offers input to Division Director on managed care contracting issues; best demonstrated practices; process improvement and utilization management activities; barriers to achieving goals and objectives of initiatives; participates in HCA Case Management and Division initiatives; including, but not limited to Medicare One Day Stay initiative.

Please consider my experience and qualifications for this position:

• Attend monthly departmental staff meetings and/or interdepartmental meetings as appropriate
• Excellent communication skills, judgment, initiative, critical thinking and problem solving abilities
• Graduate of Social Work Program, MSW preferred
• Familiar with current trends of medical practice
• PA state Registered Nursing license, BSN Preferred
• Teammate should be flexible, a fast learner, able to own and grow the program, and comfortable speaking with and recruiting patients for the program
• Discharge Planning and Medication Reconciliation background
• Assess, plan, coordinate, implement, monitor, and evaluate the care of each beneficiary under the Case Management / ICT purview across the continuum of care

I am excited to be applying for the position of case manager RN. Please accept this letter and the attached resume as my interest in this position.

Previously, I was responsible for consultation to providers on strategies to close gaps in care and reduce fragmentation of care, including leveraging care management staff to impact appointments, medication and treatment adherence.

My experience is an excellent fit for the list of requirements in this job:

• BLS certification through AHA or ARC
• Case Management or CPHQ certification strongly preferred
• Prior utilization/quality/discharge planning/and/or case management experience highly preferred
• Above average organizational/prioritization skills
• Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions smooth transition to Aetna programs and plans
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
• Assessments take into account information from various sources to address all conditions including co-morbid and
• Knowledge and competency in all types of medical necessity decisions, including in patient care, sub-acute/skilled care, outpatient care, hospice care, and home health care

I submit this application to express my sincere interest in the case manager RN position.

Previously, I was responsible for supervision to proper recording of invoice entries, proper accounting for managed facilities and those assets in our care are properly managed.

Please consider my qualifications and experience:

• Case Management, Discharge Planning or Home Health experience preferred
• Previous patient care experience in an acute or outpatient environment, working with pediatric populations
• Maintains current unrestricted Registered Nurse licensure in State of Ohio
• Experience assessing patients for home care safety and developing appropriate care plans and plan adjustments
• Prior inpatient/acute care case management experience
• Past homecare experience
• Willing to obtain WI license after hire
• Experience with discharge planning, obtaining pre-certified authorizations, insurance initial/concurrent review, and appeals

I am excited to be applying for the position of case manager RN. Please accept this letter and the attached resume as my interest in this position.

In the previous role, I was responsible for leadership and marketplace insight to Managed Markets team, sales, and internal groups on key issues including managed care trends.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Prior case management/utilization experience preferred
• Excellent time management and organizationalskills are needed as the environment can be fast paced
• Active DE Licensure, in good standing
• Case Management Certification preferred through the Commission for Case Management (CCM) or within 18 months of hire
• FL RN (Registered Nurse) License
• Recent experience within clinical acute care highly preferred
• Knowledge and understanding of Utilization Management and InterQual Criteria preferred
• Case Management Certification is desirable

I submit this application to express my sincere interest in the case manager RN position.

In the previous role, I was responsible for support to RSM’s, DSM’s and VP’s in selling managed care memberships and MRA (McKesson Reimbursement Advantage) to current and prospective McKesson customers.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Will complete paperwork and perform monthly case management contacts to meet state requirements
• Ensuring member access to services appropriate to their health needs
• Implementing care plan by facilitating authorizations / referrals as appropriate within benefits structure or through extra-contractual arrangements
• Negotiating rates of reimbursement, as applicable
• Assising in problem solving with providers, claims or service issues
• Researches and designs treatment /care plans to promote quality of care, cost effective health care services based on medical necessity complying with contract for each appropriate plan type
• Provides Referrals to Quality Management (QM), Disease Management (DM) and Appeals and Grievance department (AGD)
• Monitors Clinical Support Coordinators (non-clinical) in the performance of UM support activities, QA and regular performance audits