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
• conducts assessments to identify individual needs
• implements care plan by facilitating authorizations/referrals
• coordinates internal and external resources
• monitors and evaluates effectiveness of the care management plan
• interfaces with Medical Directors and Physician Advisors
• assists in problem solving with providers, claims or service issues
• assists with development of utilization/care management policies and procedures

Requirements

• Requires BA/BS in a health-related field
• minimum of 5 years of clinical experience
• Current, unrestricted RN license in applicable home state required
• Multi-state licensure is required if providing services in multiple states
• 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