Maryland Licensed Clinical Navigator

Job Summary

A company is looking for a Clinical Navigator (Remote).

Key Responsibilities

• Conduct concurrent reviews of inpatient care and manage transitions to appropriate levels of care
• Collaborate with medical directors and hospital teams to determine care plans and improve member experiences
• Make referrals to care management programs for chronic and long-term care coordination

Required Qualifications

• Bachelor's Degree in Nursing or 4 additional years of relevant work experience
• RN - Registered Nurse licensure in MD, VA, or Washington, DC
• 5 years of clinically related experience in Care Management, Home Health, or Utilization Review
• Knowledge of MCG and experience with Commercial and Medicare/Medicaid benefits
• CCM certification and MCG certification preferred