Description
This position reports to the office 4 days a week with a schedule of 8:30A - 5:00P
Coordinates, negotiates, procures and manages care of our members/enrollees to facilitate cost effective care and members/enrollees satisfaction. Facilitates the continuum of care, works collaboratively with interdisciplinary staff, internal and external to the organization. Responsible for carrying a complex case management case load, ownership of a case management program(s), pre- authorization reviews to provide Medically Necessary, timely and quality health care services in the most cost-effective manner and pharmacy reviews per population served. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels.
Graduate of an accredited School of Nursing Required Bachelor's degree Preferred3-4 years Case management experience Required 3-4 years UM or related experience Required 5-7 years diverse clinical experience Required 3-4 years acute inpatient care clinical experience RequiredRN - Registered Nurse - State Licensure and/or Compact State Licensure Valid RN license in the District of Columbia and/or the State of Maryland based on work location(s) Upon Hire Required and CCM - Certified Case Manager Upon Hire Preferred
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