Hybrid RN Care Manager: Care Coordination Lead

Telligen; Edmond (OK); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Telligen is seeking a Nurse Care Manager (RN) to oversee care management for patients with acute and chronic conditions across diverse client contracts. This hybrid role supports work at our Oklahoma City, OK or West Des Moines, IA offices and is contingent on securing a new contract.

The role emphasizes assessment, collaboration with providers, education, and adherence monitoring, with potential state-specific licensure requirements. Join a mission-driven population health organization.

Qualifications

• Four-year degree in health care or related field and/or equivalent training and/or experience.
• Minimum 1 year experience in human services and/or 3 years clinical practice experience.
• Licensure as a health care provider or current RN license.
• Some contracts may require state specific licensure.
• State licensure required for different clients in numerous states.
• Certain positions may require advanced certifications or the ability to obtain certifications within 4 years.

Responsibilities

• Performs assessment and evaluation of potential care management patients per client contractual obligations and/or state requirements.
• Collaborates with health care providers and ancillary service providers to validate the appropriate treatment plan and identify educational opportunities.
• Assessment/education may include face-to-face interaction for specific contracts.
• Effectively guides members to appropriate member benefit information.
• Provides ongoing education.
• Communicates with all health care providers to ensure appropriateness of care.
• May recommend and make adjustments in care if needed.
• Evaluates treatment adherence and reevaluates the patient's commitment to make the necessary changes.
• Documents per contractual requirements related to individual member status, and/or medical necessity review, negotiation.
• Escalates issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff members.
• Performs miscellaneous duties as assigned.

Skills

RN License

Care management

Hybrid work

Contract-based role

Education

Bachelor's degree in health care or related field

Equivalent training/experience

Job description

Telligen is seeking a Nurse Care Manager (RN) to oversee care management for patients with acute and chronic conditions across diverse client contracts. This hybrid role supports work at our Oklahoma City, OK or West Des Moines, IA offices and is contingent on securing a new contract.

The role emphasizes assessment, collaboration with providers, education, and adherence monitoring, with potential state-specific licensure requirements. Join a mission-driven population health organization.