About the role

  • Nurse Case Manager I coordinating care for members diagnosed with chronic illnesses. Performing care management and monitoring member health care across the care continuum.

Responsibilities

  • Work with our members diagnosed with chronic illnesses
  • Conduct assessments to identify individual needs and develop a specific care management plan
  • Implement care plan by facilitating authorizations/referrals as appropriate within benefits structure
  • Coordinate internal and external resources to meet identified needs
  • Monitor and evaluate effectiveness of the care management plan and modify as necessary
  • Interface with Medical Directors and Physician Advisors on treatment plans
  • Negotiate rates of reimbursement, as applicable
  • Assist in problem solving with providers, claims or service issues

Requirements

  • Requires BA/BS in a health related field and minimum of 3 years of clinical experience
  • Current, unrestricted RN license in applicable state(s) required
  • Multi-state licensure is required if this individual is providing services in multiple states
  • Certification as a Case Manager is preferred
  • Experience working in home health is preferred

Benefits

  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs (unless covered by a collective bargaining agreement)
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Short and long term disability benefits
  • 401(k) +match
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources

Job title

Nurse Case Manager I

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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