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Nurse Case Manager – NICU
ProgenyHealth, LLC. Assess members' physical, functional, psychological, environmental, educational, and financial needs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in assessing and addressing members' comprehensive needs through individualized care plans, effective communication, and coordination of services. Proficient in managing high-risk cases within a telephonic managed care environment while ensuring quality care and adherence to clinical standards.
Highest-signal resume keywords
RN Licensure in Texas or Compact LicensureCCM CertificationClinical Experience in Level III NICUData Entry into EHRCase Management Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Needs AssessmentIndividualized Care PlansRisk StratificationService CoordinationMonitoring ProgressDocumentation AccuracyTelephonic Managed CareCommunity Resource ReferralInterdisciplinary CollaborationQuality Care Facilitation
Soft Skills
Excellent Communication SkillsOrganizational AbilitySelf-MotivatedTeam CollaborationCustomer Service Commitment
Tools & Technologies
EHRDatabase Management
Certifications & Qualifications
RN LicensureCCM Certification
Industry Keywords
Managed CareHigh-Risk MembersMaternity ManagementClinical ExperienceHealthcare Services
About the role
Key responsibilities & impact- Assess members' physical, functional, psychological, environmental, educational, and financial needs
- Complete needs assessments and develop individualized care plans
- Assign risk stratification based on medical and social complexity
- Determine ongoing call frequency and monitor care plans
- Ensure effective and appropriate provision of services and adequacy of benefits
- Interface with providers to coordinate appointments, transportation, DME, and other services
- Educate members about conditions, treatment plans, benefits, services, and accessing care
- Monitor progress toward goals and reassess changes in health status
- Refer members to community resources and facilitate access and communication among multiple services
- Monitor service delivery and whether services meet member needs
- Participate in interdisciplinary and client rounds to identify, clarify, and prevent risk, quality, or care-plan variances
- Work in a telephonic managed care setting to facilitate quality care for high-risk members
Requirements
What you’ll need- RN licensure in Texas or Compact licensure
- Registered Nurse (RN) with a current, unrestricted license
- Three (3) or more years of clinical experience in a Level III or above NICU
- CCM certification required within the timeframe specified by company policy
- Experience with data entry into a database or EHR
- Must be computer literate
- Excellent communication skills and organizational ability
- Must be self-motivated and willing to learn multiple tasks
- Must be well organized and able to prioritize tasks
- Must demonstrate accuracy in spelling and documentation
- Demonstrated strength in working independently as well as collaboratively within a team
- Excellent interpersonal skills and telephone etiquette
- Commitment to excellence in customer service
- College degree is preferred
- Experience in a Case Management role is preferred
- Previous experience in a maternity management program preferred
Benefits
Comp & perks- Paid Time Off
- Paid Parental Leave
- Medical, dental, vision benefits
- 401K with company match
- Short- and Long-Term Disability
- Group Life Insurance
- Tuition reimbursement
- Professional development opportunities
- Business Casual work environment