Bilingual RN Case Manager, SNP - Must have California RN License (Non-Compact) Remote
Core
Coordinate care and health management for seniors and chronically ill members with complex needs, utilizing the nursing process to close care gaps and resolve barriers to improved health.
Role type
RN Case Manager (SNP)
Builds
Care coordination plans and referrals for members with chronic conditions
Domain
Healthcare / Senior Care / Chronic Disease Management
Deliverable
client delivery
Required skills
Nursing process application, care gap resolution, interdisciplinary collaboration, chronic condition management, community resource navigation, care plan implementation, self-management education support, claims/service issue resolution, care coordination with delegated providers
Preferred skills
Health Plan experience, BSN degree
Technologies
PC-based software (Word, Excel, PowerPoint)
Responsibilities
Coordinate care as a resource for members, families, and physicians; Ensure access to appropriate care and facilitate referrals/authorizations; Complete comprehensive health assessments; Collaborate with PCPs and care teams to implement care plans; Interface with specialists on treatment plans; Provide education and self-management support; Assist with problem-solving for providers and claims issues; Work with contracted providers to assure efficient care coordination
Seniority
Mid-level, hands-on IC