Job Description Summary

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Responsible for managing quality, cost effective care using selective benefits and alternative services best suited for the member.

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How will you make an impact & Requirements

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**This is a Hybrid position and requires the position holder to reside in Nevada**

Primary duties may include, but are not limited to:

• Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet member's health needs.
• Supports member or their representative in regard to care, care transitions, and changes in health status. Implements a comprehensive clinical case management plan for each patient.
• Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed.
• Analyzes patient variances from the plan and initiates the appropriate steps to resolve variances.
• Performs admission and concurrent stay reviews on hospitalized patients.
• Develops and implements discharge planning for patients in conjunction with hospital based case managers.
• Performs telephonic, fax and/or on-site reviews with skilled nursing facilities, home health agencies or other contracted service agencies to determine need for continued care.

Qualifications

• Requires a RN and minimum of 2 years of experience; or any combination of education and experience, which would provide an equivalent background.
• Current unrestricted RN NV license in applicable state(s) required.
• Satisfactory completion of a Tuberculosis test is a requirement for this position.
• Bilingual in ether Spanish or Vietnamese is preferred.

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Compensation:

$35.43

to

$53.15