Job Description
About the position Responsibilities • Ensures member access to services appropriate to their health needs. • Conducts assessments to identify individual needs and develops a specific care management plan. • Implements care plans by facilitating authorizations/referrals as appropriate. • Coordinates internal and external resources to meet identified needs. • Monitors and evaluates the effectiveness of the care management plan and modifies as necessary. • Interfaces with Medical Directors and Physician Advisors on care management treatment plans.
• Negotiates rates of reimbursement, as applicable. • Assists in problem-solving with providers, claims, or service issues. Requirements • Current, active unrestricted RN license in the state of Indiana. • BA/BS in a health-related field and minimum of 3 years of clinical experience, or equivalent education and experience. Nice-to-haves • OB nursing experience is strongly preferred. • Case management experience. • Previous managed care experience preferred. • Discharge planning experience. • Substance Use Experience is preferred.
Benefits • 401(k) • 401(k) matching • Dental insurance • Health insurance • Life insurance • Paid time off • Vision insurance Apply tot his job Apply tot his job Apply tot his job