RN Medicaid Clinical Care Specialist - Remote

We are a new, dynamic, private equity backed healthcare organization dedicated to providing high-quality care to our community. You will be working with our operations team to facilitate complex care management / care coordination for our Medicaid patients at our hospital clients nationwide - you will be the clinical subject matter expert assisting our team. Are you a self starting, mission driven RN or LCSW with case management / managed care / care coordination experience?

Assessing the medical needs of the patient to understand their full clinical picture Review health insurance benefit plans to determine if coverage options meet the needs of the patient. Coordinate patient care options with Hospital partner and providers post discharge including but not limited to pediatric hospitals, home health, pharmacy, durable medical treatment. Facilitating aspects of the treatment plan, such as care coordination and discussions with the patient and family of the patient. Recording all case information including interactions with internal and external teams. Building strong relationships with the medical team throughout the case management process. Communicating with other healthcare providers, specialists, and community services to ensure coordinated care and seamless transitions. Responding to clinically complex situations that may arise with patients within 1-2 business days. Representing the patient's needs and advocating for access to necessary services and resources. Attend as needed meetings with healthcare team members to discuss patient medical needs and obstacles in receiving care. Consistently demonstrate the ability to successfully operate in problem-solving mode whenever challenges or concerns arise.