Case Manager, Registered Nurse
Core
Coordinate care for members with chronic medical and behavioral health conditions, addressing social determinants of health (SDoH) needs through assessments, care planning, and resource connection.
Role type
Senior IC case manager (registered nurse)
Builds
Individualized care plans and seamless health care experiences for members
Domain
Healthcare / Managed Care (Medicare/Medicaid)
Deliverable
client delivery
Required skills
Registered Nurse (RN) licensure, case management, discharge planning, home healthcare coordination, disease management education, care coordination, documentation, regulatory compliance, interdisciplinary collaboration
Preferred skills
Medicare/Medicaid member care management, SDoH needs experience, chronic condition management, behavioral health experience, health assessments, English-Spanish bilingualism
Technologies
Microsoft Office Suite (Word, Excel, Outlook, OneNote, Teams), electronic health record systems
Responsibilities
Conduct telephonic engagement with members to coordinate care; Develop individualized care plans with goals and interventions; Provide evidence-based disease management education; Ensure interdisciplinary team involvement; Document care management activities in electronic health records; Collaborate to address barriers to care; Connect members with health plan benefits and community resources
Seniority
Mid-Senior level, hands-on IC