RN Field Case Manager - Telephonic WA State ONLY

Assess the health status of members, establish goals to meet identified health care needs, and plan, implement, and evaluate responses to the plan of care. Collaborate with the multidisciplinary team to engage resources addressing medical, functional, and social barriers, while consulting with the patient's PCP, specialists, or other health care professionals as appropriate. Assess patient needs for community resources, make referrals, and facilitate transitions within and between health care settings. Provide counseling and education regarding health maintenance, disease prevention, and condition trajectory, then verify and document patient understanding of the condition, plan of care, and follow-up recommendations. Maintain credentials essential for practice, including licensure, certification, and CEUs, while actively participating in organizational quality initiatives and multidisciplinary team meetings.