Job Summary:

The Nurse Care Manager is responsible for providing care coordination including in-home assessment, planning, facilitation, advocacy and authorization of covered plan services to meet the member's health needs while promoting quality cost effective outcomes.

Essential Functions:

• Ensures consistent care along the entire health care continuum by assessing and closely monitoring members’ needs and status.


• Authorizes covered services and coordinates care regardless of payer.


• Collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team.


• Works with member/family to maintain the most independent living situation possible


• Assesses, plans and provides continuous care management across all venues of care, including hospital, sub-acute, long-term and home settings.


• Regularly assesses members for ongoing eligibility for services base...