Case Manager - Registered Nurse (EST)
Core
Acts as a liaison to coordinate case management activities for catastrophic and chronically ill members, assessing medical/vocational status and developing care plans to optimize wellness and return to work.
Role type
Senior IC case manager (registered nurse)
Builds
Integrated care plans and condition management strategies for members/clients
Domain
Health insurance / Case management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Care coordination, Medical assessment, Plan of care development, Stakeholder communication, Regulatory compliance, Benefit eligibility determination, Multidisciplinary team collaboration, Outreach to physicians, Progress monitoring, Documentation
Preferred skills
Geriatric care, Multicultural experience, Certified Case Manager (CCM/CRC/CDMS/CRRN/COHN), National professional certification
Technologies
Clinical tools and information/data systems
Responsibilities
Coordinate case management activities across the continuum of care, Assess and analyze medical/vocational status of members, Develop plans of care to facilitate condition management, Communicate with stakeholders telephonically or in person, Prepare documentation of case work activities, Consult with internal multidisciplinary teams, Make outreach to treating physicians, Provide educational and prevention information, Monitor member progress toward desired outcomes
Seniority
Mid-level, hands-on IC