About this role
Role Overview
- Responsible for the coordination of services for members who meet established criteria, with an emphasis on education/self-management and promoting quality care and cost-effective outcomes.
- Uses a collaborative process to assess Member needs, review options for services and resources, develop and implement a plan of care, coordinate resources, monitor progress, evaluate Member status, and discharge Members.
- Fully document the individualized member care management process and outcome.
- Address medical, psychosocial, clinical needs, and behavioral health needs including members with mental health and substance use disorder needs.
- Provide counseling and referrals to community/local/state programs; collaborate with caregivers, providers, community agencies, behavioral health, and other resources to coordinate care to achieve member’s optimal health status.
- Responsible for the management and oversight of a caseload of moderate
- high risk Members with complex medical/behavioral /psychosocial needs.
Requirements
- At least three (3) years’ recent/related experience; care management, home health, medical/surgical behavioral health, and/or critical care preferred.
- Health plan experience preferred.
- Oncology experience preferred
- Experience in health coaching and motivational interviewing techniques preferred.
- Registered Nurse with active licensure in home state; additional state’s licensure as needed/required to meet customer needs.
- Certified Case Management certification within 2 years of employment.
- Compact RN license preferred.
Benefits
- Medical, Dental & Vision coverage
- Retirement Plan
- Generous time off including Paid Time Off
- Holidays
- Volunteer time off
- Incentive Plan
- Tuition Reimbursement
- Comprehensive benefits packaging