Summary:
The Registered Nurse Case Manager identifies, evaluates and provides management of services for patients with complex, catastrophic, long term illness or injury, mental/chemical health, and/or psychosocial issues. To promote quality, effective outcomes throughout the care continuum, the Case Manager will utilize disease management knowledge, along with evidence-based clinical care, to administer all facets of the case management process including assessment, planning, development of care plans, implementation of the plan of care, coordination and oversight of services, and evaluation of options and resources. The Case Manager acts as a member advocate through coordination and collaboration on care needs working with primary care physicians, specialists, members and their families, and community providers. The position responsibilities also include an understanding of the impact of social determinants of health and other psychosocial needs resulting in quality, cost-effective care.
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