Nurse Case Manager II managing complex health care needs via assessment and coordination of care plans for members. Working primarily virtually with some required in-person training.
Responsibilities
responsible for 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
coordinating internal and external resources
monitoring and evaluating effectiveness of the care management plan
negotiating rates of reimbursement as applicable
assisting with development of utilization/care management policies
Requirements
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
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