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Case Manager II
Job Title: Case Manager II
Job Type: Full-Time
Location: Baton Rouge, LA
Perform collaborative duties to assess, plan and coordinate continuum of care for select members at high risk in order to promote quality, cost effective programs.
Bachelor’s degree preferred. At least two years clinical nursing experience. At least two years experience managed care environment.
• Advanced review of admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care.
• Develop, assess and adjust as necessary the care plan and promote desired outcome.
• Coordinate services between Primary Care Physician (PCP) specialist, and other medical and non-medical providers as necessary to meet the complete medical socio economic needs of clients. For BCHP only, participate in face to face visits with high risk members at point of service.
• Provide patient and provider education.
• Identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Data enters assessments and authorizations into the system.
RN required. Current state nursing and driver’s license. CCM (Certified Case Manager) or other clinical certification preferred.