Registered Nurse Case Manager
Job Summary
Utilizing a collaborative process of assessment and advocacy, the full-time Registered Nurse Case Manager will conduct comprehensive evaluations of referred members' needs and eligibility, working remotely Monday to Friday from 8 am to 5 pm EST.
Key responsibilities
- Conduct comprehensive assessments of referred members' needs and eligibility using clinical tools and data review
- Determine appropriate approaches for case resolution and evaluate member benefit plans and available services
- Advocate for options and services that support individual healthcare and benefit needs while ensuring compliance with regulatory standards
Required qualifications
- Unrestricted active RN Compact license
- High School Diploma or equivalent
- At least 3 years of clinical practice experience in healthcare or managed care
- Experience in case management
- Proficiency in navigating multiple computer systems and data entry
Complete Job Description
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