Manager overseeing assessment and improvement of Welfare and Self - Reliance products and services. Ensures impactful delivery of humanitarian efforts worldwide with an emphasis on strategic evaluation and reporting.
About the role
- Pediatric Nurse Case Manager I responsible for care management of children with complex health needs. Managing care plans and coordinating resources for optimal healthcare solutions.
Responsibilities
- Performing care management within the scope of licensure for members with complex and chronic care needs
- Assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
- Performing duties telephonically or on-site for discharge planning
- Ensuring member access to services appropriate to their health needs
- Conducting assessments to identify individual needs and specific care management plan
- 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
- Modifying care plans as necessary
- Interface with Medical Directors and Physician Advisors on care management treatment plans
- Assisting 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 providing services in multiple states
- Bilingual candidates strongly preferred
- 2+ years of experience with the pediatric population strongly preferred
- Certification as a Case Manager is preferred
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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