Walk me through the day-to-day responsibilities of this the role and a description of the project (Outside of Workday JD):
Remote telephonic case management, Care manager (CM) follows model of care to assist member in managing health care needs.
Conducts initial assessments, medication review, develops care plan with member, identifies member needs and connects member with appropriate resources to meet health care needs.
Interacts with members care team, community services, vendors.
Follows up with member every 30 days at minimum to review conditions, progress toward goals, and ensure member is receiving requested information and/or services.
Provides education on member health plan and coverage and management of identified health conditions.
Describe the performance expectations/metrics for this individual and their team:
CM caseload expectation is 75 actively managed members, Audit score of 90%or greater, Case duration 90 days.
Education/Experience
Current Compact RN license
Required
Registered Nurse, 5 plus years clinical RN experience management experience
Compact License
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Staffing and Recruiting
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