The Case Manager, in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.
The hours of this role are Mon-Fri, 8am-5pm, est.
The Telephonic Case Manager employs a variety of strategies, approaches and techniques to manage a member's physical, environmental and psycho-social health issues. Identifies and resolves barriers that hinder effective care. Ensures patient is progressing towards desired outcomes by continuously monitoring patient care through assessments and/or evaluations. May create member care plans. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.
3-5 years of clinical acute care experience
Experience with case management, discharge planning and patient education for adult acute care
Licensed Registered Nurse (RN) in the (appropriate state) with no disciplinary action
Comprehensive knowledge of Microsoft Office applications including Word, Excel, and Outlook
Knowledge of Milliman or Interqual
Managed care experience
Certified Case Manager (CCM)
Scheduled Weekly Hours
Equal Opportunity Employer
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