Case Manager – Registered Nurse

Role Overview

• Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care
• Interacts with members/clients telephonically or in person
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status
• Develops a plan of care to facilitate the member/client’s appropriate condition management
• Communicates with member/client and other stakeholders
• Prepares all required documentation of case work activities
• Interacts and consults with internal multidisciplinary team
• Provides educational and prevention information for best medical outcomes
• Utilizes case management processes in compliance with regulatory and company policies and procedures
• Monitors member/client progress toward desired outcomes

Requirements

• Candidate must reside in an Eastern Standard Time Zone (EST) state
• Candidate must have active and unrestricted Compact Registered Nurse (RN) licensure in state of residence
• 2+ years of experience in care management
• 2+ years of Medicare experience
• Geriatric experience (preferred)
• Experience working in a Multicultural setting, or personal multicultural experience (preferred)
• Certified Case Manager National professional certification (CRC, CDMS, CRRN, COHN, or CCM) (preferred)
• Associate’s Degree in Nursing AND relevant experience in a health care-related field (REQUIRED)
• Bachelor’s Degree in Nursing (PREFERRED)

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• resources based on eligibility