FEP Case Manager

Role Overview

• Supporting utilization management functions for more complex and non-routine cases as needed.
• Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits
• Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Digital positions must have the ability to effectively communicate via digital channels and offer technical support.

Requirements

• License Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.
• 3 years
• Clinical experience required
• 5 years
• Experience in the health care industry
• For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required
• Excellent oral and written communication skills
• PC Skills required (Basic Microsoft Office and E-Mail)

Benefits

• Various immunizations and/or associated medical tests may be required for this position.
• Digital literacy assessment required.