Care Manager I (RN, In-Office Position) - 1106518 (20957631)
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care
- Develop, assess and adjust, as necessary, the care plan and promote desired outcome
- Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
- Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
- Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs
- Provide patient and provider education
- Facilitate member access to community based services
- Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
- Actively participate in integrated team care management rounds
- Identify related risk management quality concerns and report these scenarios to the appropriate resources
- Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
- This is NOT a remote position. Position is in-office in Harrisburg OR Pittsburgh PA from 8-5pm.
- Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
- 2+ years of clinical nursing experience in a clinical, acute care, or community setting.
- Knowledge of healthcare and managed care preferred.
Licenses/Certifications: Current state’s RN license.