Case Manager Registered Nurse
Core
Remote Registered Nurse Case Manager supporting members with complex healthcare needs through personalized care plans and health coaching.
Role type
Senior IC Registered Nurse (Case Management & Utilization Management)
Builds
Personalized care plans and health outcomes for members with complex medical needs
Domain
Health Insurance / Utilization Management
Required skills
Clinical judgment, care coordination, telephonic care management, health coaching, interdisciplinary collaboration, critical care expertise
Preferred skills
Case Management Certification (CCM), transplant nursing experience, BSN
Technologies
Microsoft Office 365, Teams, Outlook, EHR portals, VPN
Responsibilities
Assess and coordinate care for members with complex medical needs, develop proactive care plans to improve health outcomes, identify clinical and social barriers impacting care, collaborate with healthcare providers and multidisciplinary teams, utilize clinical judgment for utilization decisions, engage members through telephonic care management and health coaching
Seniority
Mid-Senior level, hands-on IC