The Case Manager / Health Coach coordinates the care and services of selected member populations across the continuum of care, promotes effective utilization and monitoring of health care resources, and assumes a collaborative role with all members of the healthcare team to achieve optimal clinical and resource outcomes.
- Serve as a team member on a multidisciplinary team that monitors utilization patterns; identifies and facilitates appropriate health care service delivery for selected members, providers, procedures, and/or diagnoses; and improves the quality and cost efficiency of care and service.The application of the Case Manager or Health
- Coach’s knowledge and clinical skills will vary across the Health Care division, dependent on focus areas identified by the business area supported.
- RN with Associate’s degree or Bachelor of Science in Nursing (BSN)
- Minimum of 3 years full-time direct clinical experience in an acute medical or acute surgical setting
- Proficiency with a Microsoft Windows operating system
- Must have valid license to practice nursing within the US and have started application for NC nursing license
- Prior experience in a variety of health care settings is preferred
- Experience with managing and coordinating care for patients who have multiple co-morbidities is preferred
- Utilization and Quality Management/Outcomes experience preferred
- Previous work experience with a managed care organization or provider is preferred
- Prior experience in case management, home health, discharge planning, or concurrent review is preferred
- For Commercial Care Management: Multi-State Licensure preferred
- Certified Case Manager (CCM) or Certified Health Coach (CHC) certification is preferred at time of hire