Job Summary

Job Duties

​Assesses, plans, implements, coordinates, monitors and evaluates all options and services with the goal of optimizing the patient or member's health status. Manages utilization and practice metrics to further refine the delivery of care model to maximize clinical, quality, and fiscal outcomes.

• Integrates evidence-based clinical guidelines, preventive guidelines, protocols, and other metrics in the development of treatment plans that are patient-centric, promoting quality and efficiency in the delivery of healthcare for the identified population.

• Develops systems of care that monitor progress and promote early intervention in acute care situations.
• Assists with the design, implementation, and evaluation of the advanced patient centered care model.
• Assesses the healthcare, educational and psychosocial needs of patients or members.
• Designs an individualized plan of care and fosters a team approach by working collaboratively with the patient or member, family, primary care provider, and other members of the health care team to ensure coordination of services.
• Continuously evaluates laboratory results, diagnostic tests, utilization patterns and other metrics to monitor quality and efficiency results for assigned population.
• Works to appropriately apply benefits and utilization management serving as a resource to the patient or member and healthcare team.
• Maintains required documentation for all case management activities.
• Collects required data and utilizes this data to adjust the treatment plan when indicated.

Work is typically performed in a clinical environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies and skills outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details

Work Schedule:

• Day Shift (Monday through Friday)
• On-Call rotation required
• Travel may be required up to 25% for meetings and home visits

We're proud to offer competitive salaries and a comprehensive benefits package that includes:

• Medical, prescription drug, vision and dental coverage
• Family Support (Fertility and Adoption Support)
• Employer contribution to your retirement plan
• Tuition assistance (part time and full time roles only)
• Generous paid time off packages that allows you to take the time you need to travel, rest, and care for and reconnect with friends and family.
• Professional opportunities for growth and advancement 
• Support and mentorship from a full range of dedicated and experienced nursing leaders
• Community Involvement through our Employee Resources Groups 
   

Education

Experience

Certification(s) and License(s)