Positions in this function include RN (with current licensure) and LPN/LVN roles that identify, coordinate, or provide appropriate levels of care under the direct supervision of an RN or MD. Function is responsible for clinical operations and medical management activities across the continuum of care (assessing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be responsible for providing health education, coaching and treatment decision support for members. Includes Health Coach, Health Educator, and Health Advocate roles that require an RN. - Reviews the work of others.- Develops innovative approaches.- Sought out as expert.- Serves as a leader/ mentor.

• Anticipates customer needs and proactively develops solutions to meet them.
• Serves as a key resource on complex and/or critical issues.
• Solves complex problems and develops innovative solutions.
• Performs complex conceptual analyses.
• Reviews work performed by others and provides recommendations for improvement.
• Forecasts and plans resource requirements.
• Authorizes deviations from standards.
• May lead functional or segment teams or projects.
• Provides explanations and information to others on the most complex issues.
• Motivates and inspires other team members. - Undergraduate degree or equivalent experience.