RN Case Manager

Emploi pas sur LinkedIn

🕒 il y a 14 jours

🇺🇸 États-Unis – Télétravail

💵 $75 000 - $95 000 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

👻 Score fantôme 4%

infoinfo

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of EXL

EXL

10 000+ employés

🏥 Santé

🛡️ Assurance

📦 Logistique

💰 €2 000 000 Venture Round en 2015-01

Healthcare • Insurance • Logistics

Choisir un partenaire digital ne concerne pas seulement les capacités — c’est également une question de collaboration et de caractère.

Description

• Perform comprehensive assessments of beneficiaries and analyze findings to identify clinical, psychosocial, and behavioral concerns and gaps in care • Develop and document individualized case management care plans with beneficiaries, families, physicians, and healthcare providers • Document concerns, goals, interventions, resources, time frames, and barriers in care plans • Coordinate and implement care plan activities to optimize benefits coverage and continuity of care across transitions • Monitor, evaluate, revise, and update care plans to achieve desired outcomes • Initiate care conferences with the Medical Director and multidisciplinary care teams for challenging cases • Advocate for beneficiaries by promoting self-determination, informed decision-making, autonomy, and self-advocacy • Educate and support beneficiaries in self-care management and access to care • Identify benefit-related, educational, healthcare, and community resources and coordinate services • Apply comprehensive case management, patient-centered care coordination, culturally sensitive care, and complex-condition management principles • Collaborate with beneficiaries, caregivers, providers, multidisciplinary teams, and community resources • Participate in training, professional development, team conferences, and meetings • Maintain clinical documentation and data accurately and timely • Comply with professional standards, organizational policies, privacy requirements, and HIPAA

🎯 Exigences

• Current, unrestricted Registered Nurse license in the state of residence and ability to obtain multi-state licensure • United States citizenship status • Ability to obtain required Security Clearance; current DOD Security Clearance preferred • Associate or bachelor's degree in nursing from an accredited institution; bachelor's degree preferred • 5+ years of clinical RN experience in direct patient care • Knowledge of case management practices and patient-centered care concepts • Proficiency in Microsoft Office, mobile technologies, and navigating multiple applications • Ability to adapt to changing priorities • Prior case management experience preferred • Case Management Certification (CCM) preferred • Experience working in an NCQA and URAC accredited case management program preferred • Telephonic case manager experience at a health plan preferred • Ability to work independently in a home office environment • Must maintain CEUs as required by applicable State Boards of Nursing and required certifications • Must adhere to applicable federal and state regulations, including HIPAA

🏖️ Avantages

• Supportive, fast-paced, and innovative work environment • Opportunity to work with experienced healthcare consultants • Exposure to diverse client business areas • Mentoring program with senior-level professional advisors • Professional growth and development opportunities • Ongoing training and professional development • Team meetings and conferences • Travel for team meetings and limited client onsite engagements (up to 5% annually)

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