RN Case Manager

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $75k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 2%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

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

Upload Resume

EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 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

🎯 Requirements

• 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

🏖️ Benefits

• 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)