Healthcare Case Manager

2 weeks ago


Decatur, Illinois, United States Get It Recruit - Transportation Full time

At Get It Recruit - Transportation, we are committed to enhancing the accessibility and satisfaction of healthcare services for both patients and providers.

Our approach is driven by a team of physicians who utilize predictive analytics and artificial intelligence to simplify administrative processes and improve the quality of healthcare delivery.

Join us in our mission to transform healthcare for the better.

Job Overview
As a Registered Nurse Case Management Specialist, you will be instrumental in improving the quality of member management while ensuring satisfaction and cost-effectiveness. This position requires close collaboration with healthcare teams to effectively navigate and optimize the healthcare system for our clients.

Key Responsibilities
1. Analyze data to determine member eligibility for the Population Health Management Program.

2. Coordinate and deliver timely, effective, and member-focused care in accordance with HMO processes.

3. Oversee case assignments, including outreach, documentation, monitoring progress, and closure.

4. Uphold reporting and documentation standards while participating in collaborative meetings with departmental staff and clients.

5. Assist members in achieving wellness and independence by addressing barriers, social determinants, and psychosocial challenges.

6. Educate members on navigating healthcare options and advocate for cost-effective interventions.

7. Support operational aspects to fulfill customer requirements and enhance satisfaction.

8. Ensure the confidentiality of medical records and sensitive data.

9. Participate in Quality Management/Utilization Management Committee Meetings and other related tasks as necessary.

Qualifications
1. Current Registered Nurse License in Illinois with up-to-date continuing education requirements.

2. A minimum of five years of diverse experience in healthcare.

3. Familiarity with case management principles, healthcare management, and reimbursement processes.

4. Proficiency in motivational interviewing and strong clinical judgment.

5. Excellent verbal and written communication skills.

6. Strong organizational, problem-solving, and time-management skills.

7. Ability to work independently and remotely, managing multiple tasks in a fast-paced environment.

8. Proficiency in MS Office Suite, including Word, Excel, Access, PDF, Outlook, etc.

9. Experience with various Electronic Medical Records (EMRs) and navigating healthcare systems.

10. Reliable high-speed internet connection and a secure home office setup.

Preferred Qualifications
1. Knowledge of utilization review, quality improvement, managed care, or community health.

2. Previous experience in Case Management or Diabetes Care.

3. Prior remote or telephonic work experience.

Compensation and Benefits
We offer a comprehensive compensation package that includes a competitive salary, medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. Additionally, we provide a flexible paid time off program that aligns with the demands of the position.

Equal Opportunity Employer
We value diversity, inclusion, and belonging as core components of our company culture. We are committed to equal opportunity employment and do not discriminate based on any protected characteristics.

Security Policy
This position adheres to all security policies and procedures to protect personal health information (PHI) and company intellectual properties.

Employment Type:
Full-Time

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