Care Manager RN

This role involves implementing utilization management strategies, reviewing healthcare services, and improving provider and member satisfaction within a healthcare organization. It requires collaboration, data analysis, and adherence to regulatory standards.

Location: Remote (PA)

Salary: $68,400–$105,900/yr

Responsibilities

• Implement care management review processes according to industry and corporate standards.
• Function in accordance with applicable laws and regulations.
• Implement care management reviews based on established criteria and policies.
• Promote quality and efficiency in care management services.
• Respect member privacy and practice within ethical principles.
• Identify and refer members for health coaching or case management interventions.
• Employ collaborative interventions to improve healthcare outcomes.
• Educate providers and vendors to streamline processes and develop relationships.
• Develop and maintain positive relationships with internal and external customers.
• Utilize outcomes data to improve care management services.

Requirements

• 3 years of related, progressive clinical experience in the area of specialization.
• Experience in a clinical setting.

Additional Information

• Position is office-based with travel requirements of 0-25%.
• Physical demands include lifting up to 25 pounds occasionally.