Nurse Care Manager
Core
Coordinate access to medical care and community resources for medically complex SoonerCare members while conducting clinical reviews and case management.
Role type
Nurse Care Manager (Clinical Case Management)
Builds
Care management plans and cost-effectiveness reports for Medicaid members
Domain
US Healthcare / Medicaid (SoonerCare)
Required skills
Clinical case management, care coordination, clinical reviews, level of care determinations, policy compliance, stakeholder collaboration, report preparation
Preferred skills
Exceptional Needs Coordinator experience, MSN, UCAT experience, aged/blind/disabled population experience, Medicaid experience, MS/Excel/Access/PowerPoint proficiency, bilingualism
Technologies
Clinical case management systems, MS Office suite (MS, Excel, Access, PowerPoint)
Responsibilities
Coordinate access to medical care and community resources; Conduct clinical reviews and document care management activities; Collaborate with intra- and inter-agency personnel; Interface with members, families, and providers to resolve issues; Monitor program adherence to state and federal guidelines; Evaluate appropriateness for healthcare services and recommend care plans
Seniority
Mid-level, hands-on IC