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