North Carolina Licensed Care Manager

Job Summary

A company is looking for an Episodic Care Manager.

Key Responsibilities

• Perform clinical reviews to assess and coordinate health care services based on medical necessity and benefits
• Collaborate with providers and internal staff to ensure effective delivery of care and document outcomes of reviews
• Communicate notifications to members and providers according to regulatory requirements and facilitate secondary case reviews as needed

Required Qualifications

• Registered Nurse (RN) with 3 years of clinical experience or Licensed Practical Nurse (LPN) with 5 years of clinical experience
• Must possess and maintain a valid clinical license (NC or compact multi-state licensure)