RN Case Manager, Military & Family Support Services

🕒 Agosto 7

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $73.950 - $105.850 / ano

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

👔 Gerente

👻 Score fantasma 3%

O que significa: quão provável esta vaga está aberta sem contratação ativa.Como ler: 60% ou mais significa que achamos que é uma vaga fantasma. Pontuações mais baixas preocupam menos.Como pontuamos: tempo em aberto, republicações, vagas abertas vs tamanho do time, rapidez para fechar vagas, e se o salário está divulgado.Observação: é uma estimativa de dados públicos, não um julgamento da empresa. Vagas reais podem ter pontuação alta, então use como uma dica, não como um fato.

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Maximus

SiteLinkedInTodas as Vagas

10.000+ funcionários

🏛️ Governo

🏥 Saúde

💼 Consultoria

💰 $7.926.732 Post-IPO Equity - Maximus em 2010-12

Government • Healthcare • Consulting

A Maximus é uma empresa de serviços do setor público que se associa a agências governamentais para modernizar e operar programas em saúde, serviços sociais, defesa, segurança nacional e órgãos civis. A empresa combina tecnologia (IA, analytics, cloud, cibersegurança), central de atendimento omnichannel e sistemas de elegibilidade/inscrição, serviços clínicos e empresariais de Medicaid, além de consultoria e capacidades de entrega de programas para melhorar a experiência do cidadão e os resultados dos programas. Com décadas de experiência governamental e escala, a Maximus apoia clientes federais, estaduais e locais com suporte operacional centrado no ser humano e modernização digital de ponta a ponta.

Descrição

• Review favorable and partially favorable determinations in accordance with applicable regulations • Render medical necessity determinations for assigned Medicare State East cases • Resolve technical issues within assigned Medicare reconsideration cases • Review cases, summarize case facts, and assess issues involved • Conduct general legal or medical research, draft proposal sections, or act as a project liaison when needed • Serve as the project Subject Matter Expert (SME) • Coordinate services, patient care, and documentation pathways for service members and their families • Liaise between military and civilian medical and non-medical agencies to support continuity of care • Conduct assessments, care planning, and evaluation to promote optimal health and successful transitions back to duty or into the civilian community • Perform other duties assigned by management

🎯 Requisitos

• Active RN license • Minimum two-year nursing degree from an accredited institution • Minimum 2 years of nursing and/or case management experience • Bachelor's degree with 5–7 years of experience consulting within the designated function • Advanced degree preferred • Case manager certification from a recognized certifying organization, or ability to obtain certification within one year of hire • Active secret clearance at minimum • Demonstrated ability to understand diagnoses and optimize client function and self-care • Knowledge of client education principles and complex medical, psychosocial, and financial problem management • Knowledge of VA/DoW Clinical Practice Guidelines • Knowledge of healthcare financial environment and population-health fiscal stewardship • Research tools for critically evaluating practices, opportunities, and outcomes • Knowledge of pharmaceuticals, including effects, side effects, and complications • Knowledge of community resources, client entitlements, and benefit eligibility • Ability to use utilization review criteria and identify quality and risk-management issues • Ability to use information systems, technology, computers, and software for data collection, tracking, trending, analysis, and presentations • Professional oral and written communication skills • Team coordination, facilitation, and communication skills • Reliable high-speed internet service • Minimum 20 Mbps download speed, or 50 Mbps for shared internet connectivity • Minimum 5 Mbps upload speed • Master's degree in Social Work (MSW) preferred • Licensed Clinical Social Worker (LCSW) licensure preferred

🏖️ Benefícios

• Flexibility designed to support work/life balance • Medical, Dental, Vision, and Prescription plans • Partially funded HSA • Life Insurance • Discounts on Auto, Home, Renters, and Pet Insurance • 401(k) Retirement Savings Plan with Company Match • PTO • Paid holidays • Extended sick leave • Short- and Long-Term Disability coverage • Employee Assistance Program (EAP) • Employee recognition platform • Tuition Reimbursement opportunities • Employee discounts and additional employee-only benefits • Wellness programs and resources • Training programs, workshops, conferences, and ongoing learning opportunities • Maximus covers costs associated with renewing required licenses and certifications • Company-issued computer equipment