Field Registered Nurse Case Manager

Field Registered Nurse Case Manager

Employment: Long Term Contract

Shift: 8:00-5:00 pm M-F

Start Date: ASAP

Will be working with Medicare Members with complex medical or behavioral health conditions or who are at high risk.

Will be traveling 60%-70% of time; the remaining time will be spent in the field, rest of the time will be working remote.

Candidate will travel to members’ homes to assess and create care plans.

Coordinate services between Primary Care Physician (PCP) specialist, and other medical and non-medical providers as necessary to meet the complete psychological, social, and medical needs of members.

• Perform collaborative duties to assess, plan and coordinate continuum of care for select members with complex medical or behavioral health conditions or are at high risk in order to promote quality, cost effective care.
• Advanced review of admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care.
• Develop, assess and adjust as necessary the care plan and promote desired outcome.
• Coordinate services between Primary Care Physician (PCP) specialist, and other medical and non-medical providers as necessary to meet the complete medical socio economic needs of clients. Participate in face to face visits with high risk members at point of service as needed. For BCHP only, participate in face to face visits with high risk members at point of service.
• Provide patient and provider education.
• Identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Data enters assessments and authorizations into the system.

• Registered Nurse
• 5+ years RN Experience if without Case Management experience