Nurse Case Management Senior Analyst

The Care Manager will promote quality cost-effective outcomes managing care needs through the continuum of care utilizing effective verbal and written communication skills and a consumerism approach through education and health advocacy to members serviced.
Ability to work independently and effectively communicate to internal and external customers in a telephonic environment.

Responsibilities:

• Establishes a collaborative relationship with client (plan participant/member), family, physician(s), and other providers to determine medical history, current health status, and assess the options for optimal outcomes.
• Promote consumerism through education and health advocacy.
• Assesses member’s health status and treatment plan and identifies any gaps or barriers to healthcare.
• Establishes a documented patient centric care management plan involving all appropriate parties (client, physician, providers, employers, etc), identifies anticipated case results/outcomes, criteria for case closure, and promotes communication within all parties involved.
• Implements, coordinates, monitor and evaluate the care management plan on an ongoing, appropriate basis.
• Adheres to professional practice within scope of licensure and certification quality assurance standards and all care management policy and procedures.
• Participates in unit and corporate training initiatives and demonstrates evidence of continuing education to maintain clinical expertise and certification as appropriate.
• Demonstrates sensitivity to culturally diverse situations, clients and customers.

40-hour schedule that supports M-F, 8 working hours each workday (exclusion of company holidays)

Minimum requirements:
Active unrestricted Registered Nurse (RN) license in state or territory of the United States. Compact RN license a required for this role.
Two years full-time equivalent of direct clinical care to the consumer.