The Registered Nurse Case Manager is responsible for assessment, facilitation, planning, and advocacy in the case management process to coordinate health care benefits for members leading to the most successful outcomes in the most cost-effective manner. The Registered Nurse Case Manager works collaboratively with members, families, and providers in the case management process, and draws on a strong knowledge base involving clinical standards and expertise, Plan benefits knowledge, and other benefits and funding resources.
This position participates in the continued development and enhancement of all aspects of the case management process, the development and coordination of services within the Medical Services Department, and the integration of Medical Services objectives in Plan activities and initiatives.
Five years of varied clinical nursing practice,
CCM preferred, mental health or substance abuse background preferred.