RN Case Manager

Manages a caseload as outlined by CASSIP and Care Management Leadership. Maintains compliance in accordance with contractual and care management requirements Assists in research, and implementation of disease management/population health programs to serve our highest complexity members. Conducts outreach and face-to-face visits at a frequency no less than determined by the enrollee’s assigned acuity level or more if needed, with each enrollee/caregiver in their homes, physician’s offices, or other mutually agreed upon locations. Assesses enrollees on enrollment and at intervals no less than determined by the enrollee’s acuity level to identify needs/barriers and close gaps in care. Identifies over/under utilization promptly, and takes appropriate action according to organizational policy. Gathers physical and mental/behavioral health, environmental, psychosocial, and educational information; the CM develops, implements, and updates an accurate, individualized comprehensive care plan for each assigned enrollee in collaboration with the PCP and/or other multi-disciplinary team members, including public agencies. #J-18808-Ljbffr