RN Case Manager
3 weeks ago
This position reports to the office 4 days a week with a schedule of 8:30A - 5:00P. The RN Case Manager will coordinate, negotiate, procure, and manage care of our members/enrollees to facilitate cost-effective care and member satisfaction. The role involves facilitating the continuum of care, working collaboratively with interdisciplinary staff, internal and external to the organization. The RN Case Manager will be responsible for carrying a complex case management case load, ownership of a case management program(s), pre-authorization reviews to provide medically necessary, timely, and quality healthcare services in the most cost-effective manner and pharmacy reviews per population served.
Responsibilities
• Coordinate and manage care of members/enrollees to facilitate cost-effective care and member satisfaction
• Facilitate the continuum of care, working collaboratively with interdisciplinary staff, internal and external to the organization
• Carry a complex case management case load, ownership of a case management program(s)
• Conduct pre-authorization reviews to provide medically necessary, timely, and quality healthcare services in the most cost-effective manner
• Conduct pharmacy reviews per population served
Requirements
This position has a hiring range of $CUSTOM.SALARY.MIN - $CUSTOM.SALARY.MAX
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