The Senior Clinical Administrative Nurse plays a key role in member engagement, spending most of their time on outbound calls to assess needs, provide education, and introduce clinical services.
They support members with healthcare navigation, care coordination, and system resources, acting as a clinical liaison with members, caregivers, and providers to ensure coordinated care.
Responsibilities include assisting with adverse determinations, educating on wellness tools, behavioral health, and emergency care, conducting outreach for admissions and discharge planning, and maintaining thorough documentation.
The role requires a current RN license, at least 2 years of acute and behavioral health nursing experience, and proficiency in computer tools.
Preferred qualifications include a bachelor’s degree, case management, managed care, and utilization management experience.
Soft skills include excellent communication, customer service, teamwork, and adaptability.
The position involves working weekday evenings and Saturdays, with compensation based on experience and qualifications.