Help elevate our patient care to a whole new level!
Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models
Facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities
Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work
Use a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes

Active and restricted RN Compact licensure
Minimum 3+ years clinical practical experience preference: (Diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
Minimum 2+ years Case Management, discharge planning and/or home health care coordination experience
Excellent analytical and problem-solving skills
Effective communications, organizational, and interpersonal skills
Ability to work independently (may require working from home)
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Efficient and Effective computer skills including navigating multiple systems and keyboarding
Willing and able to obtain multi state RN licenses if needed, company will provide
Certified Case Manager is preferred
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required
Associates degree or Nursing diploma required.
Bachelor’s degree preferred

Case Manager, Registered Nurse – Medicare

Key skills