Hybrid Senior Nurse Case Manager – Field Nurse

Posted last month

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About the role

  • Ensures member access to services appropriate to their health needs
  • Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment
  • Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements
  • Coordinates internal and external resources to meet identified needs
  • Monitors and evaluates effectiveness of the care management plan and modifies as necessary
  • Assists in problem solving with providers, claims or service issues
  • Coordinate referrals to local and statewide resources including behavioral health, housing, transportation, and food assistance
  • Partner with community health organizations, advocacy groups, and outreach teams to strengthen member connections
  • Plan, coordinate, and deliver educational events in collaboration with community partners, employers, or local health organizations
  • Provide group-based and one-on-one education on chronic conditions, medication adherence, preventive screenings, nutrition, and self-care
  • Support initiatives that address health equity and promote culturally responsive care
  • Assists with development of utilization/care management policies and procedures, chairs and schedules meetings, presents cases for discussion at Grand Rounds/Care Conferences and participates in interdepartmental and/or cross brand workgroups
  • May require the development of a focused skill set including comprehensive knowledge of specific disease process or traumatic injury and functions as preceptor for new care management staff
  • Participates in department audit activities

Requirements

  • Requires BA/BS in a health-related field and minimum of 5 years of clinical experience
  • Current, unrestricted RN license in applicable state(s) required
  • Nursing experience in Home Health, Managed Care, Case Management, or Care Coordination preferred
  • Case Management Certification preferred
  • Strong communication and presentation skills

Benefits

  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs
  • Medical, dental, vision benefits
  • Short and long term disability benefits
  • 401(k) + match
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources

Job title

Senior Nurse Case Manager – Field Nurse

Job type

Experience level

Senior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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