Description

You will provide telephonic case management and utilization review, develop and monitor individualized care plans, coordinate care with providers and payors, and track case outcomes to ensure quality and cost-effective treatment. This role is available remotely or onsite in Dubuque, IA.

Requirements

• Bilingual: ability to speak Spanish
• RN licensure in Iowa required
• Minimum 2 years clinical practice
• Case management or utilization review experience strongly preferred
• Strong communication, problem-solving, and computer skills

Responsibilities

• Provide telephonic case management and utilization review
• Develop, implement, and monitor individualized care plans
• Collaborate with healthcare providers, payors, and internal teams
• Serve as liaison between consumers and benefit administrators
• Track and report case outcomes including cost savings and quality improvements