Hybrid Pediatric Nurse Case Manager I

Posted 1 hour ago

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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

Pediatric Nurse Case Manager I

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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