Retail Market Manager overseeing retail operations and workforce management to enhance customer experience. Leading and developing teams across multiple locations, focusing on sales and operational excellence.
About the role
- Telephonic Nurse Case Manager I handling care management for members with complex healthcare needs. Role involves assessments, care plan evaluations, and coordination of resources across multiple states.
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
- conducting assessments to identify individual needs
- facilitating authorizations/referrals as appropriate
- coordinating internal and external resources to meet identified needs
- monitoring and evaluating effectiveness of the care management plan
- interfacing with Medical Directors and Physician Advisors on development of care management treatment plans
- negotiating rates of reimbursement as applicable
- assisting in problem solving with providers, claims or service issues
Requirements
- BA/BS in a health-related field
- minimum of 3 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 (preferred)
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
- paid holidays
- Paid Time Off
- medical insurance
- dental insurance
- vision insurance
- short and long term disability benefits
- wellness programs
- financial education resources
Job title
Job type
Experience level
Salary
Degree requirement
Location requirements
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