Nurse Case Manager II
Atlanta, Florida, United States of America
Full Time
5 days ago
$79,464 - $119,196 USD
Visa Sponsor
Key skills
Critical ThinkingProblem Solving
About this role
Role Overview
- Responsible for care management within the scope of licensure for members with complex and chronic care needs
- Assess, develop, implement, coordinate, monitor, and evaluate care plans
- Conduct assessments to identify individual needs and care management plans
- Implement care plans by facilitating authorizations/referrals as needed
- Coordinate internal and external resources to meet needs
- Monitor and evaluate effectiveness of care management plans
- Interface with Medical Directors and Physician Advisors on treatment plans
- Negotiate reimbursement rates as applicable
- Assist in problem solving with providers and claims/service issues
- Assist with development of utilization/care management policies and procedures
Requirements
- BA/BS in a health related field
- Minimum of 5 years of clinical experience
- Current, unrestricted RN license in applicable state(s)
- Multi-state licensure required for providing services in multiple states
- Certification as a Case Manager is preferred
- Minimum 2 years’ experience in acute care setting is preferred
- Managed Care experience is preferred
- Ability to talk and type at the same time
- Demonstrate critical thinking skills
- Experience with Microsoft Office and ability to learn new technologies quickly
Benefits
- Health insurance
- 401(k) matching
- Paid time off
- Professional development opportunities
- Equity stock purchase
- Incentive and recognition programs