Nurse Care Manager - Case Management and Disease Management

Job Description

Job Description

As a Nurse Care Manager , you will be responsible for care management of patients with acute and chronic medical conditions and the assessment of care needs of vulnerable populations for various clients. Our team currently has openings on both our Case Management team, which focuses on coordinating overall patient care, and our Disease Management team, which specializes in supporting patients with specific chronic conditions.

This is a hybrid position requiring your presence in the office two days per week, with the flexibility to work remotely on other days.

Essential Functions

• You will perform assessment and evaluation of potential care management patients per client contractual obligations and / or state requirements.
• You will collaborate with health care providers and ancillary service providers to validate appropriate treatment plans and identify educational opportunities.
• You will effectively guide members to appropriate member benefit information.
• You will provide ongoing education and communicate with all health care providers to ensure appropriateness of care.
• You may recommend and make adjustments in care if needed.
• You will evaluate treatment adherence and reevaluate the patient's commitment to make necessary changes.
• You will document per contractual requirements related to individual member status, and / or medical necessity review, negotiation.
• You will escalate issues through appropriate channels, following established hierarchical protocols between clinical and non-clinical staff members.

Requirements

Preferred Skills and Certifications

Who We Are :

Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.

Over our 50-year history, health care has evolved - and so have we. What hasn't changed is our deep commitment to those we serve. Our success is built on our ability to adapt, respond to client needs and deliver innovative, mission-driven solutions.

Our business is our people and we’re seeking talented individuals who share our passion and are ready to take ownership, make an impact and helth shape the future of health.

Are you Ready?

We’re on a mission to transform lives and economies by improving health.

Ownership :   As a 100% employee-owned company, our employee-owners drive our business and share in our success.

Community :  We show up - for our clients, our communities and each other. Being a responsible corporate partner is part of who we are.

Ingenuity :  We value bold ideas and calculated risks. Innovation thrives when we challenge the status quo and listen to diverse perspectives.

Integrity :  We foster a respectful, inclusive, and collaborative environment built on trust and excellence.

Thank you for your interest in Telligen!

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While we use artificial intelligence tools to enhance our initial screening process, all applications are thoroughly reviewed by our human recruitment team to ensure a fair and comprehensive evaluation of each candidate.

Telligen and our affiliates are Equal Opportunity Employers and E-Verify Participants.

Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time. We will not accept 3rd party solicitations from outside staffing firms.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.