Telephonic Nurse Case Manager II

Role Overview

• Responsible for care management within the scope of licensure for members with complex and chronic care needs
• Assessing, developing, implementing, coordinating, monitoring, and evaluating care plans
• Conducting assessments to identify individual needs and a specific care management plan
• Facilitating authorizations/referrals as appropriate within benefits structure
• Coordinating internal and external resources to meet identified needs
• Monitoring and evaluating effectiveness of the care management plan
• Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans

Requirements

• Requires BA/BS in a health-related field and minimum of 5 years of clinical experience
• Current, unrestricted RN license in applicable state required
• Multi-state licensure is required if this individual is providing services in multiple states
• Case Management experience preferred
• Certification as a Case Manager preferred
• Minimum 2 years’ experience in acute care setting preferred
• Managed Care experience preferred
• Ability to talk and type at the same time
• Experience with Microsoft Office and/or ability to learn new computer programs/systems/software quickly

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution
• paid holidays
• Paid Time Off
• medical, dental, vision benefits
• short and long term disability benefits
• wellness programs
• financial education resources