Registered Nurse/Case Manager - Pediatric Special Needs
RN Care Manager is responsible for providing care coordinator services to members who are enrolled in a specific program for children with special needs. Responsibilities include:
- Manages a caseload.
- Contacts enrollees at predetermined intervals based on need.
- Conducts face-to-face visits with each enrollee/caregiver in their homes, physician's offices, or other mutually agreed upon location
- Assesses members on enrollment to identify needs/barriers and close gaps in care.
- Identifies over/under utilization promptly, and takes appropriate action according to organizational policy
- Upon gathering health and mental/behavioral health, environmental, psychosocial and educational information, the CM develops, implements, and updates an accurate individualized comprehensive care coordination plan for each assigned enrollee in collaboration with the PCP and/or other multi-disciplinary team members including public agencies.
- Completes routine care coordination and care management activities with attention to quality, timeliness and in compliance with company policy and national standards.
- Unencumbered current DC RN License
- LICSW, LGSW, or LSWA preferred
- Current CPR Card
- 3-5 years of related experience in pediatric managed care and /or care management
- 3-5 years experience in clinical or community resource settings
- Effective verbal and written communication skills
- Bilingual (Spanish speaking) preferred
- Familiar with medical terminology
- Proficient with Word, Excel, & Outlook
- Strong organizational skills
- Ability to make sound decisions and use good judgment
- Ability to work under pressure and meet deadlines, while maintaining a positive attitude and providing exemplary customer service
- Ability to participate in professional, multidisciplinary meetings to include internal and external staff meetings
NRI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability.Meet Your Recruiter Julie Segor