The Case Management Registered Nurse (CM RN) works closely with our members to help them achieve optimal clinical outcomes. They are responsible for assessing, planning, implementing and coordinating case management activities with members to evaluate their needs, both telephonically and face-to-face. This may involve travel to hospitals, rehab or skilled nursing facilities and possibly member's homes, to engage with hard-to-reach members.
The ability to develop and maintain collaborative working relationships with FHCP colleagues and external vendors in providing case management services is essential to the role.
QUALIFICATIONS:
Education, skills and experience:
Current licensure in Florida as a Registered Nurse.
Minimum of 3 years clinical experience in case management or utilization review.
Previous experience with Case Management, Utilization Management, CMS and NCQA compliance requirements.
Previous experience with electronic health records and case management software.
Knowledge of Microsoft Office Suite preferred.
Must possess excellent oral and written communication skills.