The RN Case Manager is responsible for actively managing and advocating for patients. The Case Manager will be responsible for having comprehensive knowledge of the patient's medical status and performing utilization reviews to ensure care is rendered in accordance with intensity of service and severity of illness standards at all times. The Case Manager will consider physical, psychosocial, and financial assessment information in planning for, coordinating, and implementing a patient specific plan of care. Case management will include: educating patients about medication; encouraging adherence; promoting risk reduction and healthy lifestyle choices; and following up with patients to ensure medication is taken, appointments are made, and labs are completed. The Case Manager will work with providers and other multidisciplinary team members, utilizing a proactive approach, to ensure that medical care is provided based on current standards of care.
- Role Type: Hybrid remote. Nurses are required to be on-site at our Fresno location for a minimum of 2-3 days per week. Based on Operational and business needs, employee may be required to work on-site full time.
- Schedule: Standard operating hours are 8:00 AM to 5:00 PM, Monday through Friday, with a one-hour rotating lunch break. Overtime (OT) is possible but must be pre-approved.
- Focus: The role is general but with a strong focus on Utilization Management and Case Management across the board.
- Key Soft Skills: The ideal candidate must be a strong team player and capable of working independently. They must be able to triage and make decisions based on policy, with great communication skills for interacting with doctors