RN Manager, Case Management

Daily Responsibilities:

• Perform duties to conduct and manage the day to day operations of the case management functions communicating with departmental and plan administrative staff to facilitate daily department functions

• Review analyzes of activities, costs, operations and forecast data to determine progress toward stated goals and statistical/financial purposes

• Promote compliance with federal and state regulations and contractual agreements

• Develop, implement and maintain compliance with policies and procedures regarding medical case management

• Develop, implement, and maintain case management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure

• Facilitate on-going communication between case management staff, members, contracted providers, and subsidiaries