RN Complex Case Manager

Location: Buffalo, NY
Date Posted: 08-31-2018
RN Complex Case Manager – Health Plan
Buffalo, NY

Complex Case Manager Job Summary:
  • Provide case management to members with high risk or complex medical, behavioral health and/or psycho-social problems through community and home based visits and telephonic support.
  • Provide linkage to appropriate community resources, referral to appropriate care services, and communicate with providers in order to reduce health disparities and improve health care outcomes.
  • Provide oversight of outreach staff related to provision of support to members on a case by case basis.
  • Develop and implement targeted initiatives based on member preference and disease states that promote improved health care outcomes and quality of life.
Complex Case Manager Background: 
  • Valid, unrestricted state Registered Nurses (R.N.) license.
  • Requires a Bachelors of Science in Nursing, Social Work or related field; additional years of experience will be considered instead of an advanced degree.
  • Roughly 3-5 years of hospital, acute care clinical nursing experience.
  • At least 1-2 years’ experience with medical or behavioral case management/care coordination.
  • Prefer 2-4 years working with medically complex cases, multiple comorbidities, or chronic conditions.
  • Around 1-2 years’ experience in a Managed Care Organization (Health Plan/HMO/MSO/TPA/IPA/etc).
  • xperience working with Federal and State assistance programs (Medicare/Medicaid/etc).
  • Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts.
  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
410.983.9864 (CALL – TEXT – FAX)
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