Nurse Case Manager I
Core
Field-based nurse case manager assessing, developing, and coordinating care plans for members with complex and chronic care needs to optimize health and decrease hospital/ER readmissions.
Role type
Licensed RN Case Manager
Builds
Integrated care plans and referrals across the care continuum
Domain
Healthcare / Chronic Disease Management
Deliverable
client delivery
Required skills
Clinical assessment, care plan development, resource coordination, referral facilitation, telephonic communication, on-site visit management, Medicaid knowledge
Preferred skills
Case Manager certification, Home Health field visit experience, Microsoft Teams/Outlook/Word/Excel proficiency
Responsibilities
Conduct assessments to identify individual needs and develop specific care management plans; Implement care plans by facilitating referrals within benefits structures; Coordinate internal and external resources to meet identified needs; Monitor and evaluate effectiveness of care management plans; Interface with Medical Directors and Physician Advisors on treatment plans; Assist in problem solving with providers regarding claims or service issues
Seniority
Individual Contributor, Entry-to-Mid Level