Case Manager, Registered Nurse

Role Overview

• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes
• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators
• Conducts assessments considering information from various sources, such as claims
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives
• Utilizes case management processes in compliance with regulatory and company policies and procedures
• Utilizes motivational interviewing skills to ensure maximum member engagement

Requirements

• Candidate must reside in Illinois
• Candidate must possess reliable transportation and be willing and able to travel up to 25% of the time
• Candidate must have active and unrestricted Illinois Registered Nurse (RN) License
• 3-5 years clinical practical experience
• Confidence working at home/independent thinker
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• comprehensive benefits package designed to support physical, emotional, and financial well-being of colleagues and their families