This is a fully remote position, open to applicants in Louisiana, +4 more states.

📋 Description

• Evaluate the health management requirements of the designated member panel.

• Leverage data and analytics alongside professional clinical judgment to determine the appropriate clinical interventions for each member.

• Oversee a current case load of members involved in case management.

• Reach out to members participating in case management, which includes creating care plans, promoting behavior modifications, coordinating care, and identifying necessary resources.

• Track, enhance, and uphold quality outcomes for the designated panel of members.

⛳️ Requirements

• A High School Diploma or GED is required.

• A minimum of 7 years in any combination of clinical, case management, and/or disease or condition management experience, as well as provider operations and/or health insurance experience, is required.

• Current RN licensure in the State of Pennsylvania OR current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC), or in West Virginia, Delaware, or New York is required.

• Certification in Case Management is preferred.

• Advanced training and experience in cognitive behavioral therapy (CBT), motivational interviewing, or dialectical behavior therapy (DBT) is preferred.