Nurse Care Manager I (Nclex)
Core
Nurse Care Manager I 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
Care management plans and interventions for members with complex and chronic care needs
Domain
Healthcare / Health Insurance
Required skills
Clinical assessment, Care plan development, Discharge planning, Medical necessity assessment, Provider collaboration, Care plan monitoring
Preferred skills
Bilingual (English & Spanish), Home health experience, Case Manager certification, BS in nursing or health services
Technologies
None stated
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 assessment to develop goals and implement care plans, Monitor and evaluate effectiveness of care management plans
Seniority
Individual Contributor, Mid-level (3+ years experience)