RN Case Manager I – Telephonic / Field – Northeast Kansas
Core
RN Case Manager responsible for care management of members with complex and chronic care needs within the Kansas Medicaid program, performing assessments and coordinating care telephonically and on-site.
Role type
Licensed Nurse Case Manager
Builds
Care management plans and care coordination for Medicaid members
Domain
Healthcare / Medicaid / Chronic Care Management
Deliverable
physical/clinical work
Required skills
RN licensure, care plan development, care coordination, assessment, resource negotiation, problem solving
Preferred skills
Computer proficiency
Responsibilities
Conduct assessments virtually and in person to identify individual needs and develop care management plans; Implement care plans by facilitating authorizations and referrals; Coordinate internal and external resources to meet identified needs; Monitor and evaluate effectiveness of care management plans and modify as necessary; Interface with Medical Directors and Physician Advisors on treatment plans; Negotiate rates of reimbursement; Assist in problem solving with providers regarding claims or service issues.
Seniority
Individual Contributor