Nurse Case Manager

2 weeks ago

Saint Charles, United States IPMG Full time

**Nurse Case Manager - fully remote**

Join Insurance Program Managers Group (IPMG) and become part of a dynamic team committed to innovation in insurance For the past 25 years, our mission has been to create one-of-a-kind insurance solutions for our partners. We bring proactive and tailored approaches to our clients, valuing the unique contribution of each team member. Together, we shape our identity and drive transformative change for our clients

Position Summary:
What you will work on:

- Conduct initial and ongoing assessments to identify patient status and individual needs; promotes client self-determination.
- Assist in identifying appropriate providers and facilities throughout the continuum of services, while ensuring that available resources are being

used in a timely and cost-effective manner to obtain optimum value for both the client and the reimbursement source.
- Utilize appropriate resources and case management interventions to facilitate the case management plan.
- Develop a specific case management plan in collaboration with the consumer and members of the health care team with periodic updates.
- Identify short term goals, long term goals, interventions to meet goals, resources to be utilized, timeframes for re-evaluations,

and collaborative approaches to facilitate the case management plan.
- Measure and modify the interventions to determine the outcomes of the case management involvement.
- Implement care plan by facilitating authorizations and referrals, as appropriate, within benefit structure, contractual agreements,

or jurisdictional regulations, utilizing nationally accepted evidence-based criteria as guidelines for treatment protocols.
- Notify claims personnel regarding anticipated surgeries, benefit exceptions, and other significant events that may require special handling.
- Manage the disability durations proactively, utilizing nationally accepted evidence-based criteria as guidelines for duration protocols

in workers’ compensation and short-term disability.
- Collaborate and communicates effectively with employees, providers, client, employers, and internal team members.
- Performs short term disability management according to regulations, policies, and plan documents completing benefits determinations and/or making recommendations.
- Consult for serious health condition.
- Perform triage intake functions with referrals and coordination of care needs specific to client instructions.

What we would like you to join us as a Registered Nurse with:

- 1+ years of case management experience with focus in return-to-work management
- 2 years of clinical experience
- Excellent written and verbal communication skills
- Proven customer service skills
- Effective time management skills
- Overall computer proficiency including expertise in Microsoft Office Suite, especially Outlook, Word, and Excel

As well as Licenses and Certifications:

- Licensure or certification in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline.
- Two years full-time equivalent of direct clinical care to the consumer; and
- At least one of the following:

- Certification as a case manager from the URAC-approved list of certifications; or
- A bachelor’s or higher degree in a health or human services related field; or
- A current registered nurse (RN) license
- Willingness to obtain advanced certification, when eligible
- Willingness to obtain additional state licensure, as required by business needs.

Would like for you to have but not required:

- Advanced/board certification in case management
- Additional case management/utilization review experience will be considered
- Short term disability management case management experience
- Spanish Bilingual is a plus.

Travel:
Occasional travel to clients, our headquarter office in St. Charles, IL for meetings and training, and meeting our business partners. Valid driver's license is required.

Pay will be based on experience. Position is full-time, exempt.

Core Hours

8:30 a.m. to 5:00 p.m. Monday through Friday. The current flex hours for this position will be 8:00 a.m. to 5:00 p.m. Monday through Thursday and 8:30 a.m. to 3:00 p.m. on Friday. We work 37.5 hours each week to maintain full-time status. Occasional evening and weekend work may be required as essential functions demand. Servicing our client in Eastern Time zone will affect hours.
- This is a fully remote position.

OUR INTERVIEW PROCESS

IPMG has some generous benefits we want to tell you about. Here is some of our benefits and perks:

- 20 days of PTO each year
- 12 Holidays, 2 floating days of your choice and YOUR BDAY off
- Medical, dental and vision coverage on day one of full-time employment
- Telemedicine is free for you and your family (day one) if you are covered under our medical plan.
- 401k match
- Professional development support
- Flexible time off with an encourage

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