RN Case Manager

Job not on LinkedIn

🕒 September 9

🇺🇸 United States – Remote

💵 $75k - $95k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 23%

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:

• Open for 62 days.
• Jobs at this company usually fill in 31 days.
• Reposted once.

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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

• Perform comprehensive assessments of beneficiaries and analyze findings to identify clinical, psychosocial, behavioral, and care-gap concerns • Develop and document individualized case management care plans with beneficiaries, families, physicians, and healthcare providers • Document goals, evidence-based interventions, resources, timeframes, and barriers in care plans • Coordinate and implement care-plan activities to support benefits coverage, continuity of care, and service integration • Monitor, evaluate, revise, and update care plans to achieve desired outcomes • Initiate care conferences with the Medical Director and multidisciplinary care team 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, cultural sensitivity, 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, concisely, and promptly • Follow professional standards, applicable policies, federal and state regulations, patient confidentiality requirements, release-of-information rules, 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) highly desirable • Experience working in an NCQA and URAC accredited case management program preferred • Telephonic case management experience at a health plan highly desirable • Ability to work independently and collaboratively • Critical thinking and clinical problem-solving skills • Ability to work independently in a home office environment • Maintain CEUs as required by applicable State Boards of Nursing and required certifications • Willingness to obtain and maintain additional licenses as required to meet business needs • Adherence to HIPAA and applicable federal and state privacy and security regulations

🏖️ Benefits

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

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