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Case Manager, Outpatient

Job Description

Key responsibilities include the intense complex care management of members meeting the criteria of catastrophic needs.

These will include those members identified with:
  •  Acute care hospitalization(s) 
  • More than one ER visit in a quarter 
  • All cause readmissions to acute hospitals
  • Transplant work-up/wait list/follow up 
  • Skilled nursing facility stays greater than 14 days 
  • High utilization of outpatient/home health services

Job Requirements

  • CA RN
  • 3+years in Case Management or Utilization Management
  • Exposure to complex cases and chronically ill patient populations
  • Interqual or Milliman guidelines 
  • Spanish is a plus

Job Snapshot

Employment Type Full-Time
Job Type Health Care, Nurse
Education 2 Year Degree
Experience At least 3 year(s)
Manages Others No
Industry Healthcare - Health Services, Managed Care
Required Travel None
Job ID 16A*
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Case Manager, Outpatient

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