Clinical Care Manager (Registered Nurse)
: Job Details :

Coordinates and/or oversees the coordination of benefits and services for all members on his/her caseload. Completes care management and disease specific assessments. Makes timely telephonic care management calls based on risk level. Resolves and coordinates complex issues and member complaints impacting the delivery of services. Provides health education to member/caregiver. Assess S - Do. H and provide care coordination to reduce/remove barriers of care to include ability to allow for changing levels of care based on assessments, trigger events and program data/reports. Identifies member safety issues and intervenes as necessary or refers to appropriate resources, such as community linkages, dietary, therapy (PT/ OT/ ST), HHA services, behavioral health, and DME. Coordinates the delivery of high quality, cost-effective care based on a customized population model of care supported by evidence based clinical practice guidelines. Advocates for the member/caregiver to obtain the health c...Registered Nurse, Care Manager, Clinical, Manager, Registered, Nurse, Healthcare