RN Case Manager

Job not on LinkedIn

🔥 1 minute ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $80k - $83k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 11%

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 25 days.
• 60 open roles for a team of 37.

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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

• Manage case assignments through extensive patient outreach via telephone, documentation, monitoring, case progression, and case closure • 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 • Meet reporting and documentation standards • Engage in collaborative meetings with department staff and clients • Assist members with wellness and health autonomy by addressing barriers, social determinants, motivators, and psychosocial issues • Educate members on navigating the HMO and healthcare system • Promote quality and cost-effective interventions and outcomes • Support operational aspects of the division 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 rotation if applicable • Maintain continued professional growth and education reflecting current nursing care practice • Perform other responsibilities as assigned and according to annual program requirements

🎯 Requirements

• Current IL Registered Nurse License • Illinois nursing license and compliance with the Illinois Practice Act • Minimum of five years of experience in a variety of health care settings • Highly experienced in Case Management and Chronic Condition Management • Previous remote and/or telephonic work experience • Knowledge of utilization review, quality improvement, managed care, and/or community health • 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 ensure timely completion of projects and assignments • Ability to prioritize and react to rapidly changing business needs • Ability to work independently and remotely with multitasking skills for fast-paced workflows • Software knowledge including word processing and spreadsheets • Computer skills including MS Word, Excel, Access, PDF, and Outlook • Experience navigating multiple EMRs • Ability to provide internet connection with minimum 100 Mbps download and 10 Mbps upload • Certification in Case Management preferred but not required

🏖️ Benefits

• Work from home / fully remote work arrangement • Comprehensive Medical, Dental, and Vision plans • 401(k) plan with a 3% employer match to your 6% contribution • Life and Disability insurance • Voluntary Life options • Employee Assistance Program (EAP) • Paid time off plans • Paid parental leave • Learning and development resources • Necessary work equipment provided at no charge • Flexible remote work arrangement • Virtual meetings and collaboration

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