Telephonic RN Nurse Case Manager I - AmeriBen
Core
Telephonic RN Nurse Case Manager responsible for assessing, developing, implementing, coordinating, monitoring, and evaluating care plans for members with complex and chronic care needs.
Role type
Licensed RN Case Manager (Telephonic)
Builds
Care management plans and care continuum optimization
Domain
Healthcare / Medical Benefits Administration
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
RN licensure, care plan development, care coordination, benefits access education, assessment, critical thinking, multi-tasking (talk/type/think), Microsoft Office proficiency
Preferred skills
Utilization review experience, prior authorization experience, inpatient/outpatient case management experience, rapid software learning
Technologies
Microsoft Office
Responsibilities
Conduct assessments to identify individual needs and specific care management plans; Implement care plans through actions including education and facilitating authorizations/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 other health professionals on treatment plans; Assist in problem solving for members and providers related to access to care, vendors, claims or service issues
Seniority
Individual Contributor, Mid-level (3+ years experience)