Case Manager (Memphis)

About the role

In this role, you will support TennCare (Medicaid) members with complex medical, functional and social needs. You will coordinate home and community-based care, conduct required home visits, and support members transitioning to adult benefits. You’ll collaborate closely with providers and internal care teams using digital tools to identify care gaps, reduce hospitalization risk, and improve outcomes.

Responsibilities

• Support utilization management functions for more complex and non-routine cases as needed.
• Serve as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
• Oversee highly complex cases identified through various mechanisms to ensure effective implementation of interventions and efficient utilization of benefits.
• Perform the essential activities of case management: assessment, planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Communicate effectively via digital channels and provide technical support.

Requirements

• Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of residence if participating in the Nurse Licensure Compact Law.
• 3 years of clinical experience required.
• 5 years of experience in the health care industry.
• For Select Community & Katie Beckett: 2 years of experience in IDD for Select Community is required.

Skills

• Excellent oral and written communication skills.
• PC skills required (Basic Microsoft Office and E-Mail).

Certifications

• Grade 07 BBNE.

Schedule

Remote, Monday–Friday, 8:00 a.m.–5:00 p.m., with flexibility to support member needs. Travel to members’ homes in the Memphis area and surrounding counties is required. Candidates must live within 50 miles of Memphis.

Other

Various immunizations and/or associated medical tests may be required. This job requires a digital literacy assessment.