Nurse Care Manager (RN)

Telligen • Oklahoma, OK

3d • Hybrid

About The Position

The Nurse Care Manager (RN) manages care for patients with acute and chronic medical conditions and assesses the care needs of vulnerable populations for various clients. This is a hybrid position based at either Telligen’s West Des Moines, Iowa, or Oklahoma City, Oklahoma office. The position is contingent on obtaining a new, pending contract.

Requirements

• Four-year degree in health care or a related field, and/or equivalent training and/or experience.
• At least 1 year of experience in human services and/or 3 years of clinical practice experience.
• Licensure as a health care provider or a current RN license.
• State-specific licensure may be required for some contracts; state licensure is required for different clients in numerous states.
• Certain positions may require advanced certifications or the ability to obtain certifications within 4 years.

Responsibilities

• Assess and evaluate potential care management patients according to client contractual obligations and/or state requirements.
• Collaborate with health care providers and ancillary service providers to validate appropriate treatment plans and identify educational opportunities.
• Conduct face-to-face assessment or education when required by specific contracts.
• Guide members to appropriate member benefit information.
• Provide ongoing education.
• Communicate with health care providers to ensure care is appropriate.
• Recommend and make adjustments in care when needed.
• Evaluate treatment adherence and reassess patients’ commitment to making necessary changes.
• Document individual member status and medical necessity review or negotiation according to contractual requirements.
• Escalate issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff.
• Perform miscellaneous duties as assigned.

Benefits

• Benefits and other compensation are described in Telligen’s Benefits Summary; specific benefits are not listed in the posting.
• Telligen is a 100% employee-owned company.

What This Job Offers

• Job Type: Full-time