RN Case Manager – Behavioral Health

Job not on LinkedIn

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

💵 $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 11%

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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Guide Healthcare

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

🏥 Healthcare

🎯 Recruiter

Healthcare Insurance • Healthcare • Recruitment

Guide Healthcare is leading a movement where creativity delivers positive change in the healthcare sector. The company specializes in allied health service provision and healthcare recruitment, focusing on the support and treatment of older adults. With a commitment to adding value to their clients, partners, and teams, Guide Healthcare aims to do things differently in the industry.

📋 Description

• Pull, sort, and analyze data to determine member eligibility for the Population Health Management Program • Coordinate and provide timely, effective, equitable, safe, and member-centric care while following HMO processes • Manage case assignments, including outreach, documentation, case progression monitoring, and case closure • Complete reporting and documentation standards • Participate in collaborative meetings with department staff and clients • Address barriers, social determinants, member motivators, and psychosocial issues to support member wellness and health autonomy • Educate members on navigating the HMO and healthcare system • Promote quality and cost-effective interventions and outcomes • Support operational activities to meet customer requirements and satisfaction • Maintain confidentiality of computer programs, medical records, and data • Participate in QM/UM Committee Meetings, including material preparation, minutes, data collection and analysis, reporting, and follow-up tasks • Participate in off-hour/weekend call rotations if applicable • Maintain continued professional growth and education consistent with current nursing practice and the Illinois Practice Act • Perform other responsibilities as assigned and according to annual program requirements

🎯 Requirements

• Current Illinois Registered Nurse License • Complete 20 hours of continuing education per 2-year Illinois license renewal cycle • Minimum five years of experience in a variety of healthcare settings • Highly experienced in case management and chronic condition management • Knowledge of utilization review, quality improvement, managed care, and/or community health • Previous remote and/or telephonic work experience • Basic knowledge of case management principles, healthcare management, and reimbursement components • Experience with motivational interviewing • Excellent clinical judgment • Highly skilled in verbal and written communication • Strong organizational, problem-solving, and time-management skills • Ability to complete projects and assignments on time • Ability to prioritize and react to rapidly changing business needs • Ability to work independently and remotely with multitasking skills in fast-paced workflows • Software proficiency including MS Word, Excel, Access, PDF, Outlook, word processing, and spreadsheets • Experience navigating multiple EMR systems • High-speed, secure home internet connection • Private HIPAA-compliant home office with a lockable door • Backup internet connection options • Certification in Case Management preferred but not required

🏖️ Benefits

• Fully remote work arrangement • Medical, dental, and vision plans • 401(k) plan with a 3% employer match to the employee’s 6% contribution • Life and disability insurance • Voluntary life insurance options • Employee Assistance Program (EAP) • Paid time off plans • Paid parental leave • Learning and development resources • Necessary work equipment provided at no charge • Full-time employees working 30 hours per week or more are eligible for comprehensive benefits