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Case Manager RN
3 days ago
Care Manager II (RN) openings with a major health insurance / managed care company in the Lubbock, TX 79424 area Starting ASAP Apply now with Luke H. at A-Line
**Must be local to the Lubbock, TX area to assist with home visits/assessments; mileage reimbursement is provided**
Responsibilities of this Position:
- Following up on members in the upgrade process to implement services and identify doing face to face assessments
- Making outbound phone calls to members and providers to coordinate services
- Candidate needs wifi at their home during WFH. Can order laptop if they don’t have one.
- 100% telephonic follow ups – need to be able to use Excel, use spreadsheets to determine productivity
- Have to be able to use telephone and Microsoft Office, Outlook is a plus because they are coordinating member services
Pay: $35 - $45 hourly. plus mileage reimbursement
Shift: Monday-Friday 8am-5pm (one hour lunch)
Required Skills:
- Active Texas RN License – no restrictions on license
- Prior home health care experience, some hospital, some care management.
- Computer literacy, Excel, Outlook, Word
- Bilingual in Spanish, highly preferred but not required
Why Apply:
- Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability
- 401k after 1 year of employment: With employer match and profit sharing
- GREAT Hours Monday through Friday, 40 hours per week
- Competitive Pay Rate
Keywords: Utilization Review, Utilization Management, Registered Nurse, MSN, URAC, CMS, Medicare, Medicaid, Case Manager, Case Management, CCM, Certified Case Manager, Denials, Appeals, Grievances, Determination Review, HEDIS, STARS, Concurrent Review, Retrospective Review, BSN, Spanish, Bilingual, Medical Billing, Medical Coding, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls.
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