RN Case Manager

Job not on LinkedIn

🕒 August 27

🤠 Texas – Remote

🤠 Texas – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 30%

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GuideWell Source

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

GuideWell Source is a company within the GuideWell Family that focuses on accelerating innovative health solutions to market, transforming and reshaping the health industry. It specializes in healthcare delivery, providing new models and superior outcomes for patients. The company emphasizes consumerism in healthcare, engaging clients in meaningful ways. GuideWell Source offers healthcare insurance, protecting employers and consumers with coverage plans and services. The company also provides administrative and claims processing services for state and federal Medicare and Medicaid programs, establishing itself as a trusted business partner in the healthcare sector with a focus on operational excellence.

📋 Description

• Assess members’ health status and care coordination needs • Conduct inpatient review and discharge planning, and possible outpatient management • Contact patients, families, physicians, healthcare providers, community resources, provider business offices, and employers/clients • Identify and coordinate alternative treatment plans within quality-care and cost-containment guidelines • Assess clinical status and sequelae and coordinate appropriate healthcare services • Monitor health status and treatment-plan impact, altering care plans as member needs change • Identify timely and cost-effective services, resources, providers, and facilities • Develop and implement short- and long-term Case Management goals with documented care plans • Evaluate treatment-plan cost-effectiveness before and after implementation • Provide accurate and timely reporting • Review medical records to determine medical necessity • Interpret individual health plans and authorize or coordinate care according to plan provisions

🎯 Requirements

• 5+ years related work experience with a professional background in clinical nursing and patient assessment • Related Bachelor’s degree or additional related equivalent work experience • Graduate of an accredited school of nursing • RN - Registered Nurse - State Licensure • Compact State Licensure in good standing • Knowledge of medical terminology, reasonable and necessary treatment plans, delivery quality health care services and cost containment practices • Ability to collaborate with cross-operational areas within the organization • Hours: Monday to Friday 8am - 5pm Central Time

🏖️ Benefits

• Medical, dental, vision, life and global travel health insurance • Short- and long-term disability programs • Leave programs to support personal circumstances • Retirement Savings Plan with employer contribution and employer match • Paid time off • Volunteer time off • 11 holidays • Additional voluntary benefits • Comprehensive wellness program