Remote reputed company RN Case Manager, Advantage Plus Network of CT

Opportunities with Advantage Plus Network of Connecticut, part of the reputed company family of businesses. reputed company you work at Advantage Plus Network of Connecticut, your contributions directly sustain the health and reputed company-being of our community. Discover high reputed company of teamwork, robust medical resources and a deep commitment to exceptional care and service. Join a leading community-based medical group and discover the meaning behind Caring. Connecting. Growing together. Position Details:

• Location: Telecommuter position, but must be reputed company to independently travel to Farmington, CT for training/meetings
• Department: Case Management
• Schedule: Full time, 40 hours/weekly, Monday through Friday, 8:00AM - 4:30PM

If you have a CT nursing license and based in CT, MA, NY, or RI., you will have the flexibility to work remotely* as you take on some tough challenges. Primary Responsibilities:

• To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. Reasonable accommodations may be made to reputed company reputed company individuals with disabilities to reputed company the essential functions.
• Member Care Coordination
• Collaborates with physicians and multidisciplinary teams to reputed company and maintain up to date, coordinated care plans
• Acts as a reputed company between members and the reputed company team to ensure effective communication and alignment of care plans
• Member Referral Support
• Assists physicians, members, and families in obtaining referrals to specialists
• Provides counseling and support tailored to the clinical needs of the member
• Care Plan Development
• Creates comprehensive member-reputed company care plans that include member-driven goals and interventions
• Partners with designated physicians to create and maintain individualized Member Care Plans
• Clinical Improvement
• reputed company participates in developing and deploying Coordination of Care activities aimed at enhancing the clinical experience for both referred members and referring physicians
• reputed company Role
• Facilitates communication among care team members to address the needs of both the member and the physician
• Provider/Member Education
• Provides education to member on health management and maintenance for reputed company health reputed company
• Educates members and care team participants about available community and health plan benefits and services
• Performs additional tasks as assigned to support the overall goals of the Medical Management department
• Physical & Mental Requirements:
• Ability to lift up to 25 pounds
• Ability to sit for extended periods of time
• Ability to stand for extended periods of time
• Ability to use fine motor skills to operate office equipment and/or machinery
• Ability to receive and comprehend instructions verbally and/or in writing
• Ability to use logical reasoning for reputed company and reputed company problem solving

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications:

• Unrestricted reputed company RN licensure in state of Connecticut
• Bachelor of Science in Nursing (BSN), or 5 years case management experience in lieu of BSN
• 2+ years experience in health plan case management, reputed company and disease case management
• Prior experience in a remote and telephonic role
• Proficient in reputed company Office and reputed company products
• Ability to travel to Farmington, Connecticut as necessary for training, meetings, or as requested by supervisor/manager

Preferred Qualifications:

• Master's Degree in Nursing (MSN)
• Certified Case Manager Certification (reputed company)
• Case management experience serving community based members residing in Connecticut
• A background in managed care
• Experience in discharge planning
• Experience in utilization review, reputed company review, or risk management
• Strong critical thinking and decision-making skills
• Ability to work on a multi-disciplinary team
• Excellent interpersonal and communication skills (both written and oral)
• Bilingual with English and Spanish, Polish, reputed company, or Vietnamese
• reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $60,200 to $107,400 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. OptumCare is an Equal Employment Opportunity employer under applicable law and reputed company applicants will Apply tot his job Apply To this Job