Description

You will provide telephonic case management and utilization review, develop and monitor individualized care plans, and collaborate with healthcare providers and payors to coordinate care, ensuring quality outcomes and cost-effective treatment for assigned consumers.

Requirements

• RN licensure in Iowa required
• Minimum 2 years clinical practice
• Bilingual Spanish strongly preferred
• 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