The Case Management Nurse conducts comprehensive clinical assessments and develops individualized care plans to coordinate medical and behavioral health services. They monitor member progress, address barriers to care, and collaborate with interdisciplinary teams to ensure quality outcomes and regulatory compliance.
Assess members with complex medical and psychosocial needs, develop and monitor individualized care plans, and coordinate services across providers and community resources. Document case management activities, support quality and regulatory requirements, and collaborate with interdisciplinary teams to improve outcomes and reduce avoidable utilization.
The Account Executive manages day-to-day client relationships for self-funded employer groups, ensuring high satisfaction, retention, and renewal. They act as an internal advocate, coordinating with cross-functional teams to deliver seamless service and strategic insights.
The role involves developing KPIs, statistical models, and predictive analytics to monitor clinical program performance and member outcomes. The analyst will create client-facing dashboards and provide actionable insights to inform healthcare strategy and ROI.
