Care Manager RN - Foster Care

Job Description

Superior HealthPlan is seeking a dedicated Care Manager RN to join our Medical Management/Health Services team. This role requires a highly skilled clinical professional with experience in case management, assessment, and coordination of medical and support services for select members. The ideal candidate will have a strong clinical nursing background, knowledge of utilization management principles, and expertise in government-sponsored managed care programs. As a Care Manager RN, you will play a crucial role in promoting quality, cost-effective care for our members.

Responsibilities

• Assess the member's current health status, resource utilization, treatment plan, and services to develop a comprehensive care plan.
• Coordinate services between medical providers, specialists, and non-medical staff to meet clients' medical and socio-economic needs.
• Provide patient and provider education, facilitate access to community-based services, and monitor referrals made to support member care management plans.
• Participate in integrated team care management rounds, identify risk management concerns, and report related scenarios to appropriate resources.
• Enter and maintain assessments, authorizations, and clinical information in various medical management systems.
• Direct care to participating network providers, participate in case management committees, and work on special projects related to case management.

Education/Experience

Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government-sponsored managed care programs. Current state's RN license required.

Benefits

• Competitive pay with a salary range of $66,100.00 to $118,900.00 per year.
• Flexible work solutions, including remote options and hybrid work schedules.
• Health insurance coverage for you and your dependents.
• Paid time off, holidays, 401(k), stock purchase plans, and tuition reimbursement.

Superior HealthPlan offers a comprehensive benefits package, including competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, and paid time off.