Case Manager RN

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

This 100% remote Case Manager RN position involves utilizing a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs.

Responsibilities:

• Apply data-driven methods to identify members for individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost-effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and escalate quality of care issues through established channels.
• Provide high-level customer service.
• Utilize assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provide coaching, information, education, and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.

Requirements:

• Active, unrestricted RN license in state of residence.
• 3+ years of acute care experience as an RN.
• Willingness to work Monday through Friday 8:00am through 4:30pm in time zone of residence with an occasional late shift rotation.

Preferred Qualifications:

• Compact RN License or Multi-state licensure.
• Certified Case Manager (CCM).
• Managed Care experience.
• Hospital experience in ICU, CCU, Step Down, ER or OR.
• Telephonic case management and/or telephonic experience.

Work from Home Requirements:

• Direct/hardwired internet connection to a modem/router within 7 feet of computer.
• Quiet, secure and private designated home virtual work location.
• Commitment to obtaining required internet speeds and adhering to all Work From Home requirements.

Benefits:

• Comprehensive benefits package including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources.