The Nurse Care Manager (NCM) serves as care manager to members across the continuum and collaborates with care manager from vended programs, such as Behavioral Health. The NCM uses accepted criteria and guidelines to manage benefits and determine medical necessity of services provided to members in all settings. Serves as the primary liaison between HPHC clinical reviewers, the health care team, employer group, providers and the member, to ensure that members receive high quality and cost-effective care.
Required Skills/ Qualifications:
Preferred Skills/ Competencies:
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