Rn Case Manager

2 weeks ago


Chicago, United States PharmaGen Full time

When you join the **PharmaGenetics INC** team you will be apart of a growing, dedicated staff who help to get safe, accurate, and timely medication to those who need it most. As a **RN Case Manager** you will perform day-to-day operations, administrative activities; Ensures efficient pharmacy workflow and a positive patient experience. Serves as a full-time certified pharmacy technician.

**Job Overview and Summary**

The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. As a RN Case Manager you will facilitate the delivery of appropriate benefits and/or healthcare information which determines eligibility for benefits while promoting wellness activities.
- Develops, implements and supports Health Strategies, tactics, policies and programs that ensure the delivery of benefits and to establish overall member wellness and successful and timely return to work. Services and strategies, policies and programs are comprised of network management, clinical coverage, and policies.
- RN Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
- Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration.
- Services strategies policies and programs are comprised of network management and clinical coverage policies.

**Duties / Responsibilies;**
- Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
- Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality.
- Reviews prior claims to address potential impact on current case management and eligibility.
- Assessments include the member’s level of work capacity and related restrictions/limitations.
- Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
- Utilizes case management processes in compliance with regulatory and company policies and procedures.
- Implement interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

**Required Qualifications**
- Active and unrestricted RN licensure in state of residence
- 5+ years of clinical experience

**Education**
- Associate's Degree minimum

PharmaGenetics INC an EOE/AA employer, we make employment decisions based on the needs of our business and the qualifications of the individual and do not discriminate based upon race, religion, color, national origin, gender (including pregnancy or other medical conditions/needs), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. We encourage all to apply.

Pay: $71,685.00 - $78,664.00 per year

**Benefits**:

- 401(k)
- Dental insurance
- Flexible schedule
- Health insurance
- Life insurance
- Paid time off

Schedule:

- 10 hour shift
- Monday to Friday
- Weekends as needed

Work Location: In person



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