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Care Manager II (Field RN - Remote after training)

Company: Health Net, Inc.
Location: Corpus Christi
Posted on: August 14, 2019

Job Description:

Description: 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. * 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 * Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes * 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 * 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. * Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience * Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems * Direct care to participating network providers * Perform duties independently, demonstrating advanced understanding of complex care management principles. * Participate in case management committees and work on special projects related to case management as needed * Approximately 75% local travel required to visit members in assigned area

Keywords: Health Net, Inc., Corpus Christi , Care Manager II (Field RN - Remote after training), Healthcare , Corpus Christi, Texas

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