Provide telephonic complex case management and make a meaningful difference in the lives of children and their families.
Partner with members, caregivers, providers, and community resources to coordinate care, address barriers, and support the management of complex medical needs.
Facilitate seamless transitions across the continuum of care, ensuring members receive high-quality, evidence-based, and family-centered support.
Manage individual patients across the health care continuum to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Acts in a leadership function with process improvement activities for populations of patients to achieve the optimal clinical, financial, operational, and satisfaction outcomes.
Evaluate the medical necessity and appropriateness of care, optimizing patient outcomes.
Establish and promote a collaborative relationship with physicians, payers, and other members of the health care team.

Must possess knowledge of case management or utilization review as normally obtained through the completion of a bachelor's degree in case management or health care.
Requires current Registered Nurse (R.N.) license in state worked.
For assignments in an acute care setting, Basic Life Support (BLS) certification is also required.
Requires a proficiency level typically achieved with 3-5 years clinical experience.
Must have a working knowledge of care management, acute care and/or home care environments, community resources and resource/utilization management.
Must demonstrate critical thinking skills, problem-solving abilities, effective communication skills, and time management skills.
Must demonstrate ability to work effectively in an interdisciplinary team format.
For assignments in an acute care setting, must be able to work flexible hours and take rotating call after hours.
Banner Registry and Travel positions require a minimum of one year experience in an acute care hospital and/or home care setting. Experience must include working in an acute care and/or home care setting within the past 12 months as a Case Manager in the specialty area.

RN, Case Manager

Key skills