facilitate the delivery of appropriate benefits and/or healthcare information
develops, implements, and supports Health Strategies, tactics, policies, and programs
acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel
implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients
interacts with members/clients telephonically or in person
assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
communicates with member/client and other stakeholders as appropriate
prepares all required documentation of case work activities as appropriate
interacts and consults with internal multidisciplinary team
Requirements
active and unrestricted Connecticut (CT) Registered Nurse (RN) License
willing to travel 55-75% within designated areas (Yale New Haven)
3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
2+ years case management, discharge planning, and/or home health care coordination experience
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently (may require working from home)
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
certified Case Manager National professional certification (CRC, CDMS, CRRN, COHN, or CCM)