Women's Healthcare Case Manager

Job Description: • Assess member needs and create individualized care plans. • Educate and support members through some of life’s most complex transitions. • Coordinate care with OB/GYNs, PCPs, and behavioral health specialists • Monitor progress, adjust plans, and advocate for access and adherence. • Supporting utilization management functions for more complex and non-routine cases as needed. • Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits. • Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation. • Digital positions must have the ability to effectively communicate via digital channels and offer technical support. Requirements: • License Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.• 3 years - Clinical experience required • 5 years - Experience in the health care industry • For Select Community & Katie Beckett: 2 years experience in IDD for Select Community is required • Currently has a Certified Case Manager (CCM) credential or must obtain certification within 2 years of hire. • For Select Community & Katie Beckett: In addition to CCM, Certification in Developmental Disabilities Nursing (CDDN) is required at hire, or must be attained within 3 years. • Excellent oral and written communication skills • PC Skills required (Basic bolthires Office and E-Mail)Benefits: • Various immunizations and/or associated medical tests may be required for this position.• Effective 7/22/13:This Position requires an 18 month commitment before posting for other internal positions. Apply tot his job