A company is looking for a Clinical Nurse Case Disease Management.
Key Responsibilities
Conducts member assessments and develops individualized care plans
Monitors the effectiveness of care plans and coordinates with healthcare teams
Provides prior authorization and manages transplant cases, ensuring compliance with guidelines
Required Qualifications
Associate degree in nursing
Valid and active Registered Nurse (RN) license in Missouri and Kansas
3 years of full-time direct patient care clinical experience in transplant, oncology, or medical / surgical
Knowledge of URAC and NCQA guidelines and state and federal regulations
Case Management Certification within 3 years of hire or transfer to the role
Licensed Clinical • Columbus, Ohio, United States