Responsible for the coordination and efficient utilization of health care resources for the provision of quality care for all patients throughout the Continuum of Care. Will facilitate clinically appropriate and fiscally responsible patient care through communication with physicians, and all members of the health care team. The Case Manager assesses and identifies the patient's clinical findings and determines, in conjunction with the Physician Advisor/Health Plan Administration, established benefits, protocols, pathways, and evidence based medicine tools the health care services and level of care appropriate for the patient. Management is prospective through the outpatient and admission process, concurrent during hospitalization and retrospective through review of individual cases and identification of trends and patterns. The Case Manager communicates with providers of care/services to ensure appropriate levels of care. RN with at least 3 yrs clinical experience with one year of case management experience preferred.