Case Manager Registered Nurse - Field in Northern Suburbs or Chicago Illinios
Core
Coordinates case management activities to evaluate medical needs and facilitate member wellness through face-to-face and telephonic assessments.
Role type
Field-based Registered Nurse Case Manager
Builds
Member wellness strategies and care plans
Domain
Health insurance / Case management
Required skills
Clinical judgment, case management, network management, claims review, interviewing skills, regulatory compliance
Preferred skills
Integrated case management model experience, behavioral health experience
Technologies
MS Office suite
Responsibilities
Conduct face-to-face and telephonic assessments of member medical needs and benefit eligibility, develop proactive courses of action to enhance member wellness, review prior claims to address impact on case management, consult with supervisors and present cases at multidisciplinary conferences, apply clinical judgment to address complex health and social indicators, utilize interviewing skills to discern health status and needs.
Seniority
Mid-level, hands-on IC