Job Summary: Works within a team environment to provide population health and chronic condition management services, analysis and expertise for employer-sponsored health plans. Provides the execution of that process by monitoring cases, organizing disease management programs and interacting with plan members, physicians and other providers. Utilizes an integrated data warehouse and/or health plan reports for support of the health benefit program's population health management initiatives, including program utilization, disease management programs and prevention programs.
Qualifications: Current RN license to practice in NC (NC license or multi-state (compact) license). A Bachelor's Degree from a recognized college or university is preferred. Three to five years experience in medical case management or equivalent required. Experience in working with populations across the chronic condition spectrum is required. Working knowledge of health benefit plan design and operations. Ability to work with multidisciplinary teams. Excellent communication skills, both written and verbal. Excellent analytical skills that result in positive population and health plan spend outcomes.
EOE AA M/F/Vet/Disability
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