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

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