Job Title: Nurse Case Management Senior AnalystLocation: TN (Remote in TX, IL, NM, OK or TN)Contract duration: 6 months (Contract to hire)Schedule: 8am to 5pm (M-F)
Description:Delivers specific delegated tasks assigned by a supervisor within the Nurse Case Management job family.Plans, implements, and evaluates appropriate health care services in alignment with the physician’s treatment plan.Utilizes strong clinical skills to assess, plan, implement, coordinate, monitor, and evaluate care options and services to support optimal healthcare outcomes for members.Ensures case management program objectives are met by reviewing the effectiveness of alternative care services while maintaining cost-effective, high-quality care.Provides clinical assessments, health education, and utilization management support to members.Conducts prospective, concurrent, and retrospective reviews for inpatient acute care, rehabilitation, referrals, and select outpatient services.Independently manages a personal caseload and coordinates all assigned cases.Completes daily Nurse Case Management responsibilities without immediate supervision, while having access to guidance from senior team members when needed.Anticipates needs and issues through forward planning; resolves non-routine matters escalated from junior staff.
Required Qualification:Active, unrestricted Registered Nurse (RN) license is required.