Nurse Case Manager II - Field OH

Job Title:

Nurse Case Manager II - Field OH

Address:

Ohio, OH

Job Description

Conducts comprehensive assessments of referred members' needs and eligibility using clinical tools and data review.

Evaluates member's benefit plan and available internal and external programs/services to determine case resolution approach.

Interprets applicable criteria, guidelines, policies, and regulatory standards to ensure proper benefit administration.

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

Communicates effectively with members and providers to facilitate coordinated care and advocacy. Critical Information

Shift/Hours: 8am-5pm, Monday-Friday

Work Environment: Onsite as needed

Job Duration: 18.0

Remote/On-site: On-site as needed, roles primarily remote for central regions 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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