RN Case Manager

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🕒 Maio 27

🌽 Illinois – Remoto

🌽 Illinois – Remote

💵 $78.000 - $83.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Guide Healthcare

SiteLinkedInTodas as Vagas

51 - 200 funcionários

Fundada em 2018

⚕️ Seguro de Saúde

🎯 Recrutamento

Healthcare Insurance • Healthcare • Recruitment

A Guide Healthcare está liderando um movimento onde a criatividade gera mudanças positivas no setor de saúde. A empresa é especializada na prestação de serviços de saúde aliados e recrutamento na área de saúde, com foco no suporte e tratamento de idosos. Com um compromisso de agregar valor aos seus clientes, parceiros e equipes, a Guide Healthcare busca fazer as coisas de maneira diferente na indústria.

Descrição

• Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program. • Coordinating and providing care that is timely, effective, equitable, safe, and member-centric while following HMO processes. • Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure. • Meeting reporting and documentation standards while engaging in collaborative meetings with department staff and clients. • Assisting members in reaching wellness and health-autonomy by addressing barriers, social determinants, member motivators, and psychosocial issues. • Helping members make informed decisions by educating them on navigation through the HMO and healthcare spectrum while promoting quality and cost-effective interventions and outcomes. • Supporting operational aspects of the division to meet the organization’s customer requirements and satisfaction. • Maintaining confidentiality related to all computer programs, medical records, and data. • Participation in QM/UM Committee Meetings including material preparation, minutes, data collection, and analysis, reporting, and follow-up tasks which may require in-person attendance. • Rotation in off-hour/weekend calls if applicable. • Responsible for continued professional growth and education that reflects knowledge and understanding of current nursing care practice as outlined in the Illinois Practice Act. • Other responsibilities as assigned and per any changes in annual program requirements.

🎯 Requisitos

• Current and active IL Registered Nurse License. Temporary licenses or licenses that are under consideration with the Board of Nursing are not acceptable. • State of Illinois requires Nursing Professional Staff to complete 20 hours of CE per 2-year license renewal cycle. • Minimum of five years of experience in a variety of health care settings. • Highly experienced in Case Management and Chronic Condition Management. • Knowledge of utilization review, quality improvement, managed care, and/or community health. • Previous remote and/or telephonic work experience. • Basic knowledge of case management principles, healthcare management, and reimbursement components, with experience in motivational interviewing. • Excellent clinical judgment, as well as highly skilled in verbal and written communication. • Strong organizational, problem solving, and time management skills necessary. • Ability to ensure timely completion of projects and assignments. • Ability to prioritize and react based on rapidly changing business needs. • Must have ability to work independently and remotely with multi-tasking skills for fast paced workflows. • Must possess software knowledge including word processing and spreadsheets, computer skills including MS Word, Excel, Access, PDF, Outlook, etc. • Experience navigating multiple EMR’s.

🏖️ Benefícios

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs. • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered. • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution. • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected. • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times. • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals. • Support Your New Family: Guidehealth offers paid parental leave to give you the time you need. • Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.