Nurse Case Manager II - Ohio

Job Title: Nurse Case Manager II - Ohio Address: New Albany, OH Job Description Conducts comprehensive assessments of referred members' needs and eligibility using clinical tools and data review.

Evaluates members' benefit plans and internal/external programs to determine appropriate case resolution strategies.

Applies applicable criteria, guidelines, policies, and regulatory standards to ensure proper benefits administration.

Utilizes case management and quality management processes in compliance with regulatory and accreditation standards.

Collaborates with members and providers to facilitate optimal, cost-effective health outcomes.

Critical Information Schedule: 8am-5pm, Monday - Friday Remote, on-site as needed Onsite requirements: in-person visits with up to 75 travel, documentation at home Work involves sitting for extended periods, talking, listening, and using computers Work environment is typical office setting with productivity and quality expectations Education/Licenses Needed RN with current unrestricted state licensure Case Management Certification (CCM) preferred Benefits: Benefits are available to full-time employees after 90 days of employment.

A 401(k) with company match is available after 1 year of service.

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