RN: Case Manager
RN: Case Manager
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
- Perform comprehensive assessment of high risk members.
- Collaborate with primary care providers to ensure the implementation of an individualized comprehensive care plan with specific interventions designed to engage the member.
- Address identify and continuously reassess cost-efficient appropriate levels of care.
- Put non-medical support in place to ensure compliance with treatment plans (such as housing and transportation). Coordinate care transitions as needed.
- Coordinate with physicians social workers discharge planners and claims professionals in transitioning patient to appropriate level of care.
- Engage specialty resources as needed to achieve optimal resolution.
- Keep detailed records of clinical functional and fiscal outcomes during the management process. Identify opportunities for health promotion and illness prevention.
- Prevent adverse patient occurrences when possible and intervene quickly if prevention is not possible thereby minimizing poor outcomes.
- Act as patient advocate by protecting privacy and confidentiality issues.
Qualifications:
- Associates or Bachelors Degree in Nursing or related field.
- Current unrestricted state Registered Nurse license.
- Ability to analyze complex medical information and make rational decisions.
- Case Management certification.
Employment Type
Full-time
