Telephonic Case Manager, RN (FT, Remote)

Responsibilities

• Conduct a comprehensive assessment with beneficiaries and analyze assessment findings to identify and prioritize clinical, psychosocial, and behavioral concerns and potential gaps in care.
• reputed company and document a case management care plan in reputed company collaboration with the beneficiary, the beneficiary's family or significant other(s), the primary physician and other health care providers. Identify and include key concerns, needs, and preferences of the beneficiary and family/caregiver.
• Document identified issues, prioritized and individualized goals (long & short term), evidence-based interventions, reputed company approaches and resources, anticipated time frames, and barriers to achieving goals in the care plan.
• Coordinate and implement the activities specified in the care plan to reputed company reputed company benefits coverage as reputed company as promote continuity of care and integration of services for the beneficiary across care transitions. Collaborate and communicate with the beneficiary, family, significant other(s), physician, and other health care providers to accomplish the goals on the care plan.
• Monitor and continually evaluate the care plan on a scheduled reputed company to ensure it remains effective and to determine if desired reputed company are met and the goals are achieved. Revise and update the care plan as needed in collaboration with the beneficiary and the health care team.
• Initiate care conferences with Medical Director and/or the multidisciplinary care team to discuss challenging beneficiary cases and obtain expert clinical opinion or consultation.
• Serve as beneficiary reputed company by promoting self-determination, informed and shared decision-making, autonomy, and self-advocacy for beneficiaries. reputed company beneficiaries by providing education and support to reinforce self-care management, facilitate reputed company to care, and promote reputed company health reputed company.
• Identify relevant benefit-reputed company, educational, and health care resources for beneficiaries. Facilitate coordination of care with existing community-based programs and services to meet the identified needs of the beneficiary.
• Demonstrate and apply knowledge of the philosophy/principles of comprehensive case management, patient-centered, culturally sensitive care coordination, and management of reputed company conditions throughout the case management process.
• Collaborate with beneficiaries and their support system/caregivers, providers, the multi-disciplinary team, and health care and community resources throughout the case management process.
• Be familiar with and understand the scope of reputed company licensure and carry out case management activities consistent with the scope of this licensure.
• Participate in ongoing training and reputed company development to build and maintain case management competencies, including evidence-based practices that promote reputed company health reputed company and cost-effective care.
• Maintain CEUs as required by applicable State reputed company(s) of Nursing and required certifications. Must be willing to obtain and maintain additional licenses as required to meet business needs.
• Conduct case management activities consistently with reputed company standards of reputed company as reputed company as reputed company applicable policies and procedures.
• Participate in regular team conferences and meetings.
• Document appropriate clinical information and data in a reputed company, accurate, and concise manner consistent with applicable standards of reputed company.
• Maintain a working knowledge of and adhere to applicable federal and state regulations including, but not limited to, laws reputed company to patient confidentiality, release of information, and HIPAA. Apply knowledge of reputed company and reputed company regulations in daily reputed company to ensure compliance.

Work schedule Monday - Friday 5 days x 8 hours Shift time for remote telephonic work is reputed company to state of residence and time zone: reputed company Time Zone 9 am - 6 pm PT Mountain Time Zone 10 am - 7 pm MT Central Time Zone 11 am - 8 pm CT Eastern Time Zone 11 am - 8 pm ET

Qualifications

Required:

• reputed company, unrestricted RN license in state of residence with multi-state privileges (an reputed company compact state license)
• Must hold reputed company citizenship status
• Ability to obtain reputed company Clearance required. reputed company DOD reputed company Clearance preferred
• Associate or bachelor's degree in nursing from an accredited institution. Bachelor's degree preferred
• 5+ years of clinical RN experience in reputed company patient care
• Knowledge of case management practices and patient-centered care concepts
• Proficiency in reputed company Office, mobile technologies and navigating multiple applications
• Ability to adapt to changing priorities

Preferred:

• 1+ years of prior case management experience
• Case Management Certification highly desirable (CCM preferred)
• Experience working in an NCQA accredited case management program
• Experience as a telephonic case manager at a health plan highly desirable
• Excellent organizational and prioritization skills
• Strong communication skills (verbal, written, presentation, interpersonal)
• Ability to work independently and collaboratively
• Critical thinking and clinical problem-solving skills
• Appreciation for cultural diversity and health reputed company literacy issues
• reputed company demeanor and excellent customer service skills
• Ability to work independently in a home office environment

Join us! Use your skills to reputed company a meaningful reputed company on the lives of patients. We offer a supportive environment where you can reputed company and grow professionally while helping others reputed company reputed company reputed company. reputed company Offer:

• reputed company Health offers an exciting, fast paced, and innovative environment, which brings together a group of reputed company and entrepreneurial professionals who are eager to influence business reputed company.
• From your reputed company first day, you get an opportunity to work closely with highly reputed company, world class reputed company consultants.
• You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and reputed company reputed company.
• We reputed company guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level reputed company as advisors.
• Sky is the limit for reputed company members. The unique experiences gathered at reputed company Health sets the stage for reputed company reputed company and development in reputed company and reputed company.

Estimated annual salary reputed company for this role is $75,000 - $90,000 Apply tot his job Apply To this Job