RN Case Manager
1 month ago
Join us in reshaping healthcare for the better
Job Description
As an RN Case Manager, you will play a pivotal role in enhancing member management quality and maximizing satisfaction and cost-effectiveness. This role involves collaborating closely within health care teams to navigate and optimize the healthcare system for our clients.
Key Responsibilities
Utilize data analysis to assess member eligibility for the Population Health Management Program.
Coordinate and provide timely, effective, and member-centric care, following HMO processes.
Manage case assignments, including outreach, documentation, monitoring progress, and closure.
Maintain reporting and documentation standards, engaging in collaborative meetings with departmental staff and clients.
Assist members in achieving wellness and autonomy by addressing barriers, social determinants, and psychosocial issues.
Educate members on navigating healthcare options and promote cost-effective interventions.
Support operational aspects to meet customer requirements and satisfaction.
Maintain confidentiality of medical records and data.
Participate in QM/UM Committee Meetings and other related tasks as required.
Requirements
Current IL Registered Nurse License with CE requirements up-to-date.
Minimum Of Five Years Of Diverse Healthcare Experience.
Familiarity with case management principles, healthcare management, and reimbursement components.
Proficiency in motivational interviewing and strong clinical judgment.
Excellent verbal and written communication skills.
Strong organizational, problem-solving, and time-management abilities.
Ability to work independently and remotely, multitasking in a fast-paced environment.
Proficiency in MS Office Suite, including Word, Excel, Access, PDF, Outlook, etc.
Experience with multiple EMRs and navigating healthcare systems.
Reliable high-speed internet connection and a secure home office setup.
Preferred Qualifications
Knowledge of utilization review, quality improvement, managed care, or community health.
Previous experience in Case Management or Diabetes Care.
Previous remote or telephonic work experience.
Compensation And Benefits
Our comprehensive compensation package includes competitive salary, medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. We also offer a flexible paid time off program that aligns with the demands of the position.
Equal Opportunity Employer
Diversity, inclusion, and belonging are integral to our company values. We are committed to equal opportunity employment and do not discriminate based on various protected characteristics.
Security Policy
This position adheres to all security policies and procedures to safeguard PHI and company intellectual properties.
Employment Type: Full-Time
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