Pediatric Case Manager Registered Nurse – Louisiana Field

Position Summary

Coordinates all case management activities with pediatric members to evaluate medical needs and to facilitate the overall wellness of pediatric members. Develops strategy to address issues to out- comes and opportunities to enhance members overall wellness through integration.

Instructs programs and procedures in compliance with network management and clinical coverage policies.

Required Qualifications

• Must reside in Louisiana in one of the following parishes: Region-1: Orleans, Jefferson, St. Bernard and Plaquemines parishes.
• current/Active Clinical Licensure (RN,)
• Case Management experience
• Strong customer service orientation and problem solving
• Excellent Communication/Telephonic skills
• Excellent motivational interviewing skills/ability to built rapport and trust
• telephonically
• Excellence in documentation and respecting compliance/regulatory standards
• Highly organized, remain self-driven without direct supervision
• Manage time effectively
• Achieve performance metrics
• Technology proficiency
• Ability to travel within 125 miles round trip for 1 day in the field
• Variable work scheduled with ability to work 2 days weekly until 9pm local
• time.
• Pediatric experience

Preferred Qualifications

• Bachelors and/or Master's Degree
• CCM Certification
• Previous experience in Managed Care Organization

Education

• Bachelors and/or Master's Degree

Anticipated Weekly Hours: 40

Time Type: Full time