Manager

• Perform care management within scope of licensure for members with complex and chronic care needs
• Assess, develop, implement, coordinate, monitor, and evaluate individualized care plans
• Conduct telephonic discharge planning
• Facilitate authorizations/referrals within benefits structure or via extra-contractual arrangements
• Coordinate internal and external resources to meet identified member needs
• Monitor and evaluate effectiveness of care management plans and modify as necessary
• Interface with Medical Directors and Physician Advisors on care management treatment plans
• Negotiate rates of reimbursement, as applicable
• Assist in problem solving with providers, claims, or service issues
• Work virtually full-time with required in-person training sessions; participate in onboarding and skill development

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