About the role

  • Nurse Case Manager II providing telephonic care management for members with complex care needs. Assessing and coordinating care plans while ensuring member access to appropriate services.

Responsibilities

  • Responsible for telephonic care management for members with complex and chronic care needs
  • Assessing, developing, implementing, coordinating, monitoring, and evaluating care plans
  • Conducting assessments to identify individual needs
  • Implementing care plan by facilitating authorizations/referrals as appropriate
  • Coordinating internal and external resources to meet identified needs
  • Monitoring and evaluating effectiveness of the care management plan
  • Negotiating rates of reimbursement as applicable
  • Assisting in problem solving with providers, claims, or service issues
  • Assisting with development of utilization/care management policies and procedures

Requirements

  • Requires BA/BS in a health-related field
  • Minimum of 5 years of clinical experience
  • Current, unrestricted RN license in applicable state(s)
  • Multi-state licensure is required if providing services in multiple states
  • Certification as a Case Manager is preferred.

Benefits

  • comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401k contribution
  • Paid Time Off
  • paid holidays
  • medical insurance
  • dental insurance
  • vision insurance
  • short and long term disability benefits
  • wellness programs
  • financial education resources

Job title

Nurse Case Manager II

Job type

Experience level

Mid levelSenior

Salary

$79,456 - $119,204 per year

Degree requirement

Bachelor's Degree

Location requirements

Report this job

See something inaccurate? Let us know and we'll update the listing.

Report job