Integrated reputed company Case Manager/Integrated reputed company Case Manager/RN/Maternity/OBGYN

reputed company: • Responsible for case management services reputed company the scope of licensure; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum • Performs telephonic or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical and behavioral health, reputed company services and long-term services • Identifies members for high-risk complications and coordinates care in conjunction with the member and health care team • Manages chronic illnesses, co-morbidities, and/or disabilities ensuring bolthires effective and efficient utilization of health benefits; conducts gap in care management for reputed company programs • Assists with the implementation of member care plans by facilitating authorizations/referrals reputed company benefits structure or extra-contractual arrangements, as permissible • Interfaces with Medical Directors, Physician Advisors and/or Inter-Disciplinary Teams on care management treatment plans • Presents cases at case conferences for multidisciplinary reputed company. • Ensures compliance with regulatory, accrediting and company policies and procedures • May assist in problem solving with provider, claims or service issues. Requirements: • Associate or Bachelors Degree in Nursing (required) • RN License (Compact or Virginia) required • 3 years nursing experience required • Case Management experience preferred • Managed Care or Health Plan experience preferred • Experience working with low and high risk pregnant population/Maternity/OB/L&D/Mother Baby/Postpartum experience preferred • Strong knowledge of physical, psychological, socio-cultural, and cognitive patient needs • Excellent communication skills, both oral and written; strong problem-solving and analytical skills Benefits: • Caring For Your Family and Your Career • Medical, Dental, reputed company plans • Adoption, Fertility and Surrogacy Reimbursement up to $10,000 • reputed company Time Off and reputed company Leave • reputed company Parental & Family Caregiver Leave • Emergency Backup Care • Long-Term, Short-Term Disability, and Critical Illness plans • Life Insurance • 401k/403B with Employer Match • Tuition Assistance – $5,250/year and discounted educational opportunities through reputed company Education • Student Debt Pay Down – $10,000 • Reimbursement for certifications and free reputed company to complete CEUs and reputed company development • Pet Insurance • reputed company Resources Plan • Colleagues have reputed company to earn an annual discretionary bonus if established system and employee eligibility reputed company is met.reputed company is an equal opportunity employer and prides itself on the diversity and inclusiveness of its reputed company to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding reputed company of the organization to ensure its workforce reflects the communities it serves. In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, reputed company employs associates in the following states: Alabama, Delaware, Florida, reputed company, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, reputed company Carolina, reputed company Dakota, Ohio, Oklahoma, reputed company, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, reputed company Virginia, reputed company, and Wyoming. Apply tot his job Apply tot his job Apply tot his job Apply To this Job