Remote RN Care Manager – NICU – Missouri

Position Purpose:

Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care

• Develop, assess and adjust, as necessary, the care plan and promote desired outcome

• Assess the member’s current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options

• Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients

• Develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member’s needs

• Provide patient and provider education

• Facilitate member access to community based services

• Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan

• Actively participate in integrated team care management rounds

• Identify related risk management quality concerns and report these scenarios to the appropriate resources

• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems

Candidate’s must reside in the state of Missouri

Qualifications

Education/Experience:

Have a current Missouri Nursing License

Graduate from an Accredited School of Nursing.

Bachelor’s degree in Nursing preferred.

2+ years of pediatric clinical nursing experience in a clinical, acute care, or community setting.

Knowledge of healthcare and managed care preferred.

Licenses/Certifications: Current state’s RN license.

*OB, NICU, postpartum experience

*Work-from-home case management role