Nurse Care Manager I (Nclex)
Core
A licensed nurse responsible for collaborating with healthcare providers and consumers to drive personalized health management and improve health outcomes for members with complex and chronic care needs.
Role type
Licensed Nurse (RN) Care Manager
Builds
Personalized care plans and health management strategies for members with complex/chronic conditions
Domain
Healthcare / Health Insurance / Care Management
Required skills
Clinical assessment, Care plan development, Discharge planning, Medical necessity review, Provider collaboration, Outcome monitoring
Preferred skills
Bilingual (English/Spanish), Home health experience, Case Manager certification, Acute care experience
Technologies
Electronic Health Records (EHR), Telehealth platforms
Responsibilities
Assess medical necessity of inpatient admissions and extensions of stay, Partner with physician clinical reviewers to interpret appropriateness of care, Collaborate with providers to assess consumer needs for discharge planning, Conduct clinical assessments to develop and implement care plans, Monitor and evaluate effectiveness of care management plans
Seniority
Individual Contributor (IC), Mid-level