Care Management Nurse
- Full Time
Overview: Care Management Nurse Burlington, WA Bring your experience to a role where you will: Provide clinical care management (such as case management, disease management, and/or care coordination) to best meet the member s specific healthcare needs and to promote quality and cost-effective outcomes. Oversee a collaborative process with the member and those involved in the member s care to assess, plan, implement, coordinate, monitor and evaluate care as needed. Responsibilities & Requirements Minimum Requirements Knowledge of health insurance industry trends, technology and contractual arrangements. General computer skills (including use of Microsoft Office, Outlook, internet search). Familiarity with health care documentation systems. Strong oral, written and interpersonal communication and customer service skills. Ability to interpret policies and procedures, make decisions, and communicate complex topics effectively. Strong organization and time management skills with the ability to manage workload independently. Ability to think critically and make decision within individual role and responsibility. Normally to be proficient in the competencies listed above: Care Management Nurse would have a/an Associate or Bachelor s Degree in Nursing or related field and 3 years of case management, utilization management, disease management, or behavioral health case management experience or equivalent combination of education and experience. Required Licenses, Certifications, Registration, Etc. Must have licensure or certification, in a state or territory of the United States, in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice for the discipline (e. g. medical vs. behavioral health) and at least 3 years (or full time equivalent) of direct clinical care Must have at least one of the following: Certification as a case manager from the URAC-approved list of certifications; or Bachelor s degree (or higher) in a health or human services-related field (psychiatric RN or Master s degree in Behavioral Health preferred for behavioral health care management); or Registered nurse (RN) license (must have a current unrestricted RN license for medical care management) About Us Regence employees are part of the larger Cambia family of companies, which seeks to drive innovative health solutions. We offer a competitive salary and a generous benefits package. We are an equal opportunity employer dedicated to workforce diversity and a drug and tobacco-free workplace. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, age, sex, sexual orientation, gender identity, disability, protected veteran status or any other status protected by law. A drug screen and background check is required. Regence is 2. 2 million members, here for our families, co-workers and neighbors, helping each other be and stay healthy and provide support in time of need. We've been here for members more than 90 years. Regence is a nonprofit health care company offering individual and group medical, dental, vision and life insurance, Medicare and other government programs as well as pharmacy benefit management. We are the largest health insurer in the Northwest/Intermountain Region, serving members as Regence BlueShield of Idaho, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah and Regence BlueShield (in Washington). Each plan is an independent licensee of the Blue Cross and Blue Shield Association. If you re seeking a career that affects change in the health care system, consider joining our team at Cambia Health Solutions. We advocate for transforming the health care system by making health care more affordable and accessible, increasing consumers engagement in their health care decisions, and offering a diverse range of products and services that promote the health and well-being of our members. Cambia's portfolio of companies spans health care information technology and software development; retail health care; health insurance plans that carry the Blue Cross and Blue Shield brands; pharmacy benefit management; life, disability, dental, vision and other lines of protection; alternative solutions to health care access and free-standing health and wellness solutions.