Case Manager – Registered Nurse
$60,522–$129,615 year
RemoteUnited States
Job Summary
Coordinate catastrophic and chronic care cases by assessing medical status, developing care plans, and facilitating integrative functions across the continuum of care. Act as a liaison with members, families, providers, and insurers to optimize wellness, aid timely return to work, and determine benefit eligibility. Conduct telephonic and in-person outreach, including home visits and physician consultations, while preparing required documentation and monitoring progress toward desired outcomes. Apply all relevant laws, regulations, and insurance carrier instructions to ensure compliance with regulatory policies and company procedures.
Required Qualifications
- 3+ years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members
- 2+ years case management, discharge planning and/or home health care coordination experience
- Candidate must have active and unrestricted Compact Registered Nurse (RN) License in their state of residence
- Associate's Degree in Nursing or Nursing Diploma (REQUIRED)
- Active and unrestricted Compact Registered Nurse (RN) License in their state of residence
Desired Qualifications
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills
- Ability to work independently (may require working from home)
- Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
- Efficient and effective computer skills including navigating multiple systems and keyboarding
- Willing and able to obtain single state Registered Nurse (RN) licenses if needed, company will provide
- Certified Case Manager
- National professional certification (CRC, CDMS, CRRN, COHN, or CCM)
- Bachelor's Degree in Nursing (PREFERRED)
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