State Licensed Nurse Care Coordinator

To support high-risk members' needs, the full-time remote State Licensed Nurse Care Coordinator will provide proactive utilization management, facilitate communication among interdisciplinary care teams, and ensure high-quality care coordination. Key responsibilities Deliver exceptional service to members and providers through various communication channels while reviewing cases with external health plan risk teams Conduct intake assessments, coordinate treatment plans, and evaluate clinical data to implement action-oriented member goals Process referrals and prior authorizations in a timely manner, ensuring coordinated, high-value care for members Required qualifications Active RN, BSN or MSN, NP in good standing 1-3 years of clinical experience in a healthcare setting Customer service experience in a health care environment Prior care coordination experience preferred Certified Case Manager preferred