This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Oversee the coordination of services for members who fulfill predetermined criteria.

• Employ a collaborative approach to evaluate Member needs, explore service and resource options, and formulate and execute a care plan.

• Track progress, assess Member status, transition Members, and thoroughly document the personalized member care management process and results.

• Offer counseling and referrals to local, state, and community programs; work in conjunction with caregivers, providers, community agencies, behavioral health professionals, and other resources to ensure coordinated care.

⛳️ Requirements

• A minimum of three (3) years of recent and relevant experience in care management, home health, medical/surgical behavioral health, and/or critical care is preferred.

• Active Registered Nurse licensure in the home state; additional state licensure as required to meet client demands.

• Certification in Case Management to be obtained within two years of employment.

• Familiarity with NCQA standards for Population Health Management aimed at health plan accreditation.

• Understanding of clinical and managed care principles and operations.