Description:

Nurse Case Manager is responsible for telephonically (remotely) assessing, planning, implementing, and coordinating all case management activities with patients to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. In this role, you would be responsible for: Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical needs Provide patient and provider education.

Education And Experience

• Nursing Diploma or Associates degree in nursing required.
• Bachelor's degree in nursing strongly preferred.
• 3 years of clinical nursing experience in a clinical, acute/post-acute care, and community setting required.
• 1 year of case management experience in a managed care setting strongly preferred.
• Experience managing patients telephonically and via digital channels (mobile applications and messaging) preferred.

Certificates, Licenses, Registrations

• Current, active, and unrestricted Registered Nurse license required
• Certification in Case Management (CCM) preferred, please send proof of licensure.
• Certification in Chronic Care Professional (CCP) preferred

Qualifications

• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
• The requirements listed below are representative of the knowledge, skill, and/or ability required.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Other Skills And Abilities

• Ability to think critically, be decisive, and problem solve a variety of topics that can impact a member's outcomes.
• Empathetic, supportive and a good listener.
• Proficient in motivational interviewing skills.
• Demonstrated time management skills.
• Organizational skills with the ability to manage multiple systems/tools, while simultaneously interacting with a member.
• Must have intermediate computer knowledge, typing capability and proficiency in Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.).
• Must embrace teamwork but can also work independently.
• Excellent interpersonal and communication skills both written and verbal.