Case Management RN
Job Summary
The Case Management RN will join the Clinical Concierge Team to educate members on health outcomes and assist with care transitions. You will work to ensure comprehensive support for members while participating in process improvement programs. This position reports directly to the Case Management Supervisor and requires occasional travel for team events.
Responsibilities
- Coordinate care across inpatient, outpatient, and home settings
- Develop care plans for members with health challenges
- Collaborate with hospital case managers on discharge planning
- Educate members on health conditions, medications, and procedures
Required Skills
- Active, unrestricted RN licensure
- 2+ years clinical/care management experience
- 1+ year care coordination experience
- Compact multistate license preferred
Job Details
Responsibilities:
- Help coordinate care across a variety of settings (inpatient, outpatient, post acute, ER, home care)
- Reach out to members undergoing difficult health challenges and develop care plans
- Reach out to hospital case managers to assist with discharge planning
- Communicate with members by phone or secure messaging to provide education on health conditions, new medications, and procedures
- Compliance with all applicable laws and regulations
- Other responsibilities as assigned
Requirements:
- Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license
- Obtain additional state licenses to meet our needs
- 2+ years of clinical experience to include hospital, outpatient or community-based care management
- 1+ years of experience in Care Coordination and Navigation
Preferred Qualifications:
- BSN
- Working knowledge of Milliman Guidelines
- CCM Certification
- Behavioral Health experience