Case Manager RN

Job description

The telephonic RN Case Manager position is responsible for utilizing the nursing process in the development of member treatment plans. The Case Manager will establish member goals and implement interventions to optimize member health care across an assigned patient case- load in order to promote high quality healthcare appropriate for the member’s clinical needs. - Improve member health outcomes by successfully managing a member caseload from a variety of care management referral sources. - Conduct telephonic member assessments to identify member care coordination needs; develop, with member and provider as appropriate, a specific care management plan to address member goals and interventions as identified during assessments. - Manage members with chronic illness, co-morbidities, and/or complex health conditions to ensure the member receives quality health care in the most cost- effective and efficient delivery of healthcare benefits. - Provide member and/or caregiver self- management strategies and ensure member receives appropriate level of post -care education to include education on condition(s), medication, benefits, and resources to optimize highest level of function. - Ident...