Nurse, Care Coordinator

Job Description:

• Provide proactive utilization management services for Teladoc Health members with high-risk needs, inappropriate urgent or emergent care utilization, and/or complex medication needs
• Deliver customer service to members, providers, care team members, and external facilities through written, telephone, and video communication
• Review member cases with external health plan risk teams and provide advice, direction, and support
• Meet with members and patient navigators after primary care appointments to review and update plans of care
• Establish and retain patient documentation in external referral and care coordination systems
• Process referrals and prior authorizations
• Manage daily assignments to meet department-specific performance metrics
• Conduct intake assessments, coordinate treatment plans, and reassess services
• Coordinate high-value, in-network care to optimize health outcomes
• Determine member eligibility and refer members to support services
• Evaluate and interpret clinical data to identify high-risk members and implement action-oriented goals
• Analyze complex clinical situations and provide appropriate solutions
• Perform medication reconciliation

Requirements:

• Active RN, BSN or MSN, NP in good standing
• 1-3 years of clinical experience
• Customer service experience in a health care setting
• Ability to work independently and as part of a high performing team
• Ability to receive work instruction and maintain department productivity standards
• Exceptional customer service skills
• Strong data analysis and clinical assessment skills
• Excellent written and verbal communications skills
• Strong time management and organizational skills
• Ability to manage multiple, competing priorities
• High degree of computer literacy and ability to manage multiple systems, including Microsoft software
• Ability to learn new procedures and adapt to changes in a fast-paced working environment
• Must be currently authorized to work in the United States without visa sponsorship now or in the future
• Certified Case Manager preferred
• Prior care coordination experience preferred
• Virtual work experience preferred
• Bilingual (English/Spanish) a plus

Benefits:

• Performance bonus eligibility
• Flexible Vacation Policy
• 80 hours of Paid Sick, Safe, and Caregiver Leave annually
• Benefits program for employees and families, subject to eligibility requirements
• Career growth and development opportunities
• Inclusive workplace and community
• Innovative culture
• Candidate resources and recruiter support