RN Case Manager

🔥 1 hour ago

🥔 Idaho, North Dakota, +4 more states – Remote

🥔 Idaho – Remote 🌾 North Dakota – Remote 🌲 Oregon – Remote ❄️ Minnesota – Remote ⛷️ Utah – Remote ☕ Washington – Remote

💵 $73k - $92.7k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 21 days.

Apply Now

Find Similar Remote Jobs

Arkansas Blue Cross and Blue Shield

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1948

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Arkansas Blue Cross and Blue Shield is a health insurance provider licensed to offer health plans in all 75 counties of Arkansas. The company offers a wide range of insurance products including individual and family plans, Medicare and Medigap plans, dental and vision plans, as well as health plans for travelers and employer group plans. They provide members with personalized services such as health management through the Blueprint Portal, where users can manage their health plan, review claims, find healthcare providers, and estimate treatment costs. Arkansas Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association.

📋 Description

• Assess, plan, implement, coordinate, monitor, and evaluate options and services required to meet individual health needs • Use plan benefits and community resources to support cost effectiveness and cost containment • Practice nursing within the scope of licensure and comply with policies, regulations, URAC standards, and state regulations • Provide specialized education on disease-specific conditions • Maintain current knowledge of medical and surgical procedures, healthcare services, drugs, and healthcare delivery trends • Liaise with patients, families/caregivers, physicians, hospital discharge planners, home care providers, and ancillary providers • Proactively review referrals, identify case-management candidates, explain services, obtain voluntary agreement, and maintain a patient caseload • Perform other duties as assigned

🎯 Requirements

• Bachelor's degree in Nursing preferred • Registered Nurse (RN) with current active state license in good standing in the state(s) where job duties are performed required • Case management certification required; if not obtained prior to employment, must obtain URAC-recognized certification within three years of hire • Acceptable case management certifications: Certified Case Manager (CCM), Accredited Case Manager (ACM), and Registered Nurse - Board Certified (RN-BC) • Minimum four years of clinical practice experience in case management, home health, critical care, medical/surgical, discharge planning, concurrent review, or obstetric/neonatal care • Independence • Detail oriented • Work from home within Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota • Knowledge of listed systems and tools including Affinite CM, Affinite UM, CCI Edits, Five9, Microsoft Excel, Microsoft Office, Microsoft Outlook, and Microsoft PowerPoint

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume