Nurse Care Manager Lead - Case Management (RN)
About the role
The Nurse Care Manager Lead is responsible for care management of patients with acute and chronic medical conditions for various clients, plus acts as a subject matter expert and mentor to employees on the team.
Responsibilities
- Perform assessment and evaluation of potential care management patients per client contractual obligations and/or state requirements.
- Collaborate with health care providers and ancillary service providers to validate the appropriate treatment plan and identify educational opportunities.
- Effectively guide members to appropriate member benefit information.
- Provide ongoing education.
- Communicate with all health care providers to ensure appropriateness of care.
- Recommend and make adjustments in care if needed.
- Evaluate treatment adherence and reevaluate the patient’s commitment to make the necessary changes.
- Be available for assistance to team members and manager.
- Absorb as mentor to new employees and assist in orientation.
- May assist with audits or quality monitoring as well as coordinating workload distribution.
- Escalate issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff members.
- Document per contractual requirements related to individual member status, medical necessity review, negotiation.
- Recommend changes in policy or procedures to ensure a competitive advantage.
- Stay abreast of health care trends and changes.
Requirements
- Four year degree in health care or related field and/or equivalent training and/or experience.
- Graduation from an accredited nursing school required.
- Current Registered Nurse (RN) license or licensure as a health care provider required.
- Minimum three (3) years of clinical practice experience.
- Demonstrated leadership capabilities.
- Ability to obtain required license(s) in state(s) by timeframe set by business not to exceed 6 months.
Preferred Qualifications
- Bachelor of Science in Nursing (BSN).
- Oncology (Onc) experience.
- Experience supporting members with acute and chronic medical conditions.
- Experience with care management and interdisciplinary care coordination.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Benefits
Telligen does not specify benefits details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not specify benefits details.
Benefits
Telligen does not specify benefits details.
Pay
Telligen does not specify pay details.
Schedule
Telligen does not specify schedule details.
Qualifications
Telligen does not specify qualifications details.
Skills
Telligen does not specify skills details.
Benefits
Telligen does not