What are the responsibilities and job description for the Nurse Case Manager II position at Careerbuilder-US?
Our Client, a Retail Pharmacy company, is seeking a Nurse Case Manager II to support their operations in Franklin, Union, Delaware, Pickaway, and Madison Counties in Ohio.
Key Responsibilities:
- Conduct comprehensive assessments of referred members' needs by evaluating their benefit plan and available internal and external programs/services, using clinical tools and information/data review.
- Apply applicable criteria and guidelines to create standardized case management plans, ensuring compliance with regulatory standards, policies, and procedures.
- Determine the most effective approach to case resolution and/or meeting members' needs through the evaluation of their benefits and available programs.
- Utilize case management and quality management processes to ensure compliance with regulatory guidelines, company policies, and accreditation standards.
