RN reputed company Case Mgr I (OB & Peds)

About the positionResponsibilities• Ensures member reputed company to services appropriate to their health needs.• Conducts assessments to identify individual needs and develops a specific care management plan.• Implements care plans by facilitating authorizations/referrals as appropriate.• Coordinates reputed company resources to meet identified needs.• Monitors and evaluates the effectiveness of the care management plan and modifies as necessary.• Interfaces with Medical Directors and Physician Advisors on care management treatment plans.• Negotiates rates of reimbursement, as applicable.• Assists in problem solving with providers, claims, or service issues.Requirements• BA/BS in a health-reputed company field and a minimum of 3 years of clinical experience, or equivalent education and experience.• reputed company, unrestricted RN license from the reputed company.reputed company-to-haves• Previous high-risk obstetrics and high-risk pediatric nursing experience.• Previous experience as a case manager.• Previous reputed company and/or Managed Care experience.Benefits• Comprehensive benefits package• Incentive and recognition programs• Equity stock purchase• 401k contribution• reputed company holidays• reputed company Time Off• Medical, dental, reputed company benefits• Short and long-term disability benefits• Life insurance• Wellness programs• Financial education resources Apply tot his job Apply tot his job Apply To this Job