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.

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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

• Conduct comprehensive assessments and analyze findings to identify and prioritize 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 issues, goals, evidence-based interventions, resources, time frames, and barriers in care plans • Coordinate and implement care plan activities, benefits coverage, continuity of care, and service integration across care transitions • Monitor and evaluate care plans, outcomes, and goals; revise plans as needed • Initiate care conferences with the Medical Director and multidisciplinary care team for challenging cases • Advocate for beneficiaries and promote self-determination, shared decision-making, autonomy, self-advocacy, and self-care management • Identify benefit-related, educational, healthcare, and community resources and facilitate care coordination • Apply comprehensive case management, patient-centered, culturally sensitive care coordination, and complex-condition management principles • Collaborate with beneficiaries, caregivers, providers, multidisciplinary teams, and community resources • Participate in training, professional development, team conferences, and meetings • Document clinical information accurately and timely • Follow professional standards, policies, procedures, applicable regulations, privacy requirements, and HIPAA

🎯 Requirements

• Current, unrestricted Registered Nurse license in the state of residence • Ability to obtain multi-state licensure • United States citizenship required • 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 be willing to obtain and maintain additional licenses as required to meet business needs • Knowledge of applicable federal and state regulations, patient confidentiality, release of information, and HIPAA

🏖️ Benefits

• Supportive, fast-paced, innovative work environment • Opportunity to work closely with experienced healthcare consultants • Exposure to multiple aspects of clients’ businesses • Mentoring program with senior-level professional advisors • Professional growth and development opportunities • Ongoing training and professional development • Team meetings and collaboration opportunities