Remote Pediatric Case Manager

Remote Pediatric Case Manager !
Job Description
The Pediatric Case Manager (Population Health & Concierge Care Coordination Care Coordinator, RN) plays a critical role in managing complex and chronic conditions across a pediatric population within a managed care environment. This nurse collaborates closely with providers, hospitals, and multidisciplinary teams to coordinate care, close gaps, and improve health outcomes while reducing avoidable utilization. The Care Coordinator conducts comprehensive needs assessments, stratifies risk, and develops individualized care plans aligned with evidence-based guidelines. The role includes reviewing inpatient census activity, coordinating discharges, conducting outreach to high-risk members, and providing disease-specific education that empowers patients and families in self-management. This position operates in compliance with Medicaid requirements, patient-centered medical home (PCMH) standards, and organizational policies to support cos...