Nurse Case Manager 1 100% Virtual, Carebridge
Core
A licensed nurse who assesses, develops, implements, coordinates, monitors, and evaluates care plans for members with complex and chronic care needs to optimize healthcare across the care continuum.
Role type
Licensed Nurse Case Manager
Builds
Individualized care management plans and care coordination for members with complex/chronic needs
Domain
Healthcare / Home and Community-Based Services
Required skills
Clinical assessment, care plan development, care coordination, resource negotiation, provider interface, care plan evaluation
Preferred skills
Case management certification, prior case management experience, home health experience
Technologies
Telephony, hospital discharge planning systems
Responsibilities
Conduct assessments to identify individual needs and develop specific care management plans; Facilitate authorizations and referrals within benefits structure; 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 and assist in problem solving with providers or claims issues
Seniority
Individual Contributor, Entry to Mid-Level