RN Care Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate long-term care services for Extended MLTC members through assessment and member-centered care planning, direct provider coordination and collaboration to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes.
RN Care Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate long-term care services for Extended MLTC members through assessment and member-centered care planning, direct provider coordination and collaboration to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes.
RN Care Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate long-term care services for Extended MLTC members through assessment and member-centered care planning, direct provider coordination and collaboration to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes.
Professional, who assesses psychosocial status, interprets the social and emotional factor related to health problems and provided counseling, referral to community resources and crisis interventions in addition to assisting with discharge planning.
Pre-screens all potential enrollee’s eligibility for MLTC services and ensures all pre-enrollment criteria are met prior to scheduling visit. Collaborates with Medicaid Specialist as needed to assist with consumer’s Medicaid eligibility.
Representative will be responsible for assisting in service claim review and other data analysis, assisting with provider claim inquiries/appeals, and supporting the department as needed.
Representative will be responsible for ensuring excellent and efficient customer service, ensuring that all covered services are authorized and placed in a timely manner, as well as provide support for all functions of the Extended MLTC as required.
