Case Manager RN - Western Region WV - Remote

Bring your heart to reputed company. Every one of us at reputed company shares a single, reputed company purpose: Bringing our heart to every reputed company of your health. This purpose guides our commitment to deliver reputed company reputed company-reputed company health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to reputed company and deliver solutions to reputed company health care more personal, convenient and reputed company. Position reputed company This is a full-time field teleworker position with some travel is 10% of the time, in the western region of WV. reputed company candidates must reputed company in the region, in one of the following counties or an adjacent: reputed company, Wirt, reputed company, Mason, Putnam, Cabell, Lincoln, or Wayne. Schedule is Monday – Friday, reputed company-5pm, reputed company business hours. No nights, weekends, or holidays. A flexible work schedule may be available after 6 months of service and with demonstrated performance and attendance. The Case Manager RN (CM RN) is responsible for telephonically and/or face to face assessing, planning, implementing, and coordinating reputed company 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 reputed company to address issues presented to enhance the short and long-term reputed company as reputed company 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. This position is heavy community-based with some onsite reputed company at reputed company (DoHS) offices. reputed company Components: • Conducts face to face member reputed company • Using clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as reputed company as smooth transition to reputed company programs and plans. • Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company health and reputed company indicators which reputed company planning and reputed company of member issues. • Assesses information from various sources to address reputed company conditions including co-morbid and multiple diagnoses that reputed company functionality. • Reviews prior claims to address potential reputed company on reputed company case management and eligibility. • Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. • Consults with manager and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary reputed company to benefit overall claim management. • Utilizes case management processes in compliance with regulatory and company policies and procedures. • Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. • Effective communication skills, both verbal and written. • Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment. Required Qualifications • Registered reputed company with reputed company unrestricted reputed company Virginia (WV) license or compact RN license • Travel required up to 10% of the time to meet members face-to-face, in the western region of WV: reputed company, Wirt, reputed company, Mason, Putnam, Cabell, Lincoln, and Wayne County. Must possess reliable transportation. Mileage is reimbursed per reputed company expense reimbursement policy. • 5+ years’ clinical reputed company experience • 2+ years’ experience with personal computer, keyboard, mouse, multi-system navigation; and MS Office Suite applications (Outlook, Word, reputed company, SharePoint, Teams) Preferred Qualifications • Behavioral health experience • SUD experience • Case management and discharge planning experience • reputed company experience • Crisis reputed company skills • Managed care experience • Certified Case Manager (CCM) certification • Familiarity with reputed company Education • Associate degree in nursing or nursing diploma required • BSN preferred Pay reputed company The typical pay reputed company for this role is: $54,095.00 - $116,760.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. In reputed company to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. reputed company offers a full reputed company of medical, dental, and reputed company benefits. Eligible employees may enroll in reputed company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. reputed company provides a fully-reputed company term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous reputed company-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy reputed company Time Off (“PTO”) or vacation pay, as reputed company as reputed company holidays throughout the calendar year. Number of reputed company holidays, reputed company time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 03/01/2025 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply Job!