North Carolina Licensed Care Manager

Job Summary

A company is looking for an Episodic Care Manager responsible for performing clinical reviews and coordinating health care services for members.

Key Responsibilities

• Conduct clinical evaluations and reviews for assigned member services to assess medical necessity
• Collaborate with internal and external staff to coordinate care and document outcomes of reviews
• Provide notifications to members and providers in accordance with regulatory requirements

Required Qualifications

• Registered Nurse (RN) with 3 years of clinical experience or Licensed Practical Nurse (LPN) with 5 years of clinical experience
• Valid and applicable clinical license (NC or compact multi-state licensure)