North Carolina Licensed Case Manager

Job Summary

A company is looking for a Case Manager - Medicare Advantage.

Key Responsibilities

• Coordinate care, resources, and services for members to achieve optimal clinical outcomes
• Develop and monitor member-centric care plans tailored to individual needs and barriers
• Educate members and facilitate proactive interventions to improve health outcomes

Required Qualifications

• RN with 3 years of clinical and/or case management experience required
• Must maintain a valid clinical license (NC or compact multi-state licensure)
• Additional specialty certification (e.g., CCM, CDCES) may be required for some roles
• Ability to assess medical necessity and appropriateness of services
• Experience in developing policies/procedures and training materials is a plus