RN Case Manager: Care Coordination Lead

Visa Hunt; United States; Hybrid; USD 72,000 - 75,000; Full time

Job summary

MedWatch, LLC is seeking a Registered Nurse Case Manager to oversee an individual caseload using the Case Management process to address members' needs, authorize services, review treatment plans, and maintain communication with the health care team. The role emphasizes compliance with URAC standards and collaboration with payers and providers.

Ideal candidates hold an active RN license, prefer a Bachelor's in a health-related field, and bring strong organizational, communication, and

Qualifications

• Active Registered Nurse license in the United States or territories.
• Bachelor's degree in a health-related field preferred.
• 7 years of varied clinical experience preferred.

Responsibilities

• Review medical data to establish and maintain a Case Management plan with providers, payers, patient and caregiver.
• Assess problems and determine goals and actions to meet patient needs; document in case notes.
• Contact payer offices to understand benefit constraints affecting the plan of action.
• Adhere to company policies as stated in the employee handbook.
• Participate in Quality Management Program and identify opportunities for improvement.
• Duties may change at any time with or without notice.

Skills

Organizational skills

Verbal and written communication

Diplomacy in difficult situations

Problem solving

MS Office proficiency

Education

RN licensure

Bachelor's degree preferred

Tools

MS Word

MS Excel

MS PowerPoint

Job description

MedWatch, LLC is seeking a Registered Nurse Case Manager to oversee an individual caseload using the Case Management process to address members' needs, authorize services, review treatment plans, and maintain communication with the health care team. The role emphasizes compliance with URAC standards and collaboration with payers and providers.

Ideal candidates hold an active RN license, prefer a Bachelor's in a health-related field, and bring strong organizational, communication, and