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Clinical Case Manager RN Field - WV
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$54,095.6 - $116,800
Full-time
- Position SummaryNurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
- Services strategies policies and programs are comprised of network management and clinical coverage policies.
- Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans.
- Reviews prior claims to address potential impact on current case management and eligibility.
- Required QualificationsMust reside in Boone, Greenbrier, Logan, McDowell, Mercer, Mingo, Monroe, Pocahontas, Raleigh Summers, or Wyoming County.
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