Ambulatory Case Manager, RN or LVN
About The Position
The Ambulatory Case Manager, RN is responsible for providing comprehensive care coordination and case management services to members, ensuring seamless transitions of care, promoting health stabilization, and reducing avoidable hospitalizations. The PHP Ambulatory Case Management team is responsible for High-Risk Case Management, Complex Case Management (CCM), Special Needs Plan Case Management (SNP) and Care Coordination including Transitions of Care. This role requires strong knowledge of case management programs, health plan benefits, managed care principles, and community resources. Will engage with members, families, healthcare providers, and multidisciplinary teams to create and implement individualized care plans. Serves as a liaison between key stakeholders including members, providers, and health plans.
Requirements
- Strong knowledge of case management programs.
- Strong knowledge of health plan benefits.
- Strong knowledge of managed care principles.
- Strong knowledge of community resources.
- RN or LVN license
Responsibilities
- Providing comprehensive care coordination and case management services to members.
- Ensuring seamless transitions of care.
- Promoting health stabilization.
- Reducing avoidable hospitalizations.
- Engaging with members, families, healthcare providers, and multidisciplinary teams to create and implement individualized care plans.
- Serving as a liaison between key stakeholders including members, providers, and health plans.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
