✨ About The Role
- Responsible for completing comprehensive assessments of members and determining eligibility for case management based on clinical judgment and assessment triggers
- Develops and implements case management plans in collaboration with members, caregivers, physicians, and healthcare professionals to address member needs and goals
- Conducts ongoing monitoring of care plans, evaluates effectiveness, documents interventions, and suggests changes as needed
- Maintains an ongoing member case load for regular outreach and management, promoting integration of services for members
- Facilitates interdisciplinary care team meetings, conducts medication reconciliation, and provides consultation and education as needed
âš¡ Requirements
- Ideal for a registered nurse with 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings
- Requires strong clinical judgment and the ability to assess members for case management based on health changes and psychosocial wellness
- Must be comfortable conducting face-to-face or home visits as needed and have excellent communication skills to collaborate with members, caregivers, and healthcare professionals
- Experience in promoting integration of services, conducting care coordination, and addressing barriers to care is essential
- Ability to educate, support, and motivate change in members using motivational interviewing techniques