Telephonic Nurse Case Manager I
Core
Telephonic care management for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans.
Role type
Licensed RN case manager (telephonic)
Builds
Care management plans and care continuum optimization
Domain
Healthcare / Insurance
Required skills
RN licensure, care plan development, resource coordination, medical director/physician advisor interface, utilization management, critical thinking
Preferred skills
Case management certification, multitasking (talk and type), MS Office proficiency, email/instant message management
Responsibilities
Conduct assessments to identify individual needs and specific care management plans, implement care plans by facilitating authorizations/referrals, coordinate internal and external resources, monitor and evaluate effectiveness of care management plans, interface with Medical Directors and Physician Advisors, assist with development of utilization/care management policies and procedures
Seniority
Mid-level, individual contributor