Coordinate care across settings: inpatient, outpatient, post-acute, ER, home care
Reach out to members with complex health challenges and develop care plans
Coordinate discharge planning with hospital case managers
Educate members via phone or secure messaging on conditions, meds, procedures
Ensure CCM NCQA standards in daily practice and workflows
Comply with all applicable laws and regulations
Other duties as assigned

🎯 Requirements

Active unrestricted RN license in US (state) or compact multi-state license
Ability to obtain additional state licenses as needed
2+ years clinical experience in payer, hospital, outpatient or community care management
1+ year experience in care coordination and navigation
CCM Certification
NCQA knowledge/accreditation experience

🎁 Benefits

Medical, dental, and vision benefits
11 paid holidays
Paid sick time
Paid parental leave
401(k) plan participation
Life and disability insurance

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