Case Manager

Job not on LinkedIn

🔥 17 hours ago

🇺🇸 United States – Remote

💵 $35 - $38 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Independent Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🛡️ Insurance

Healthcare • Healthcare Insurance • Insurance

Independent Health is one of Western New York's first Health Maintenance Organizations (HMOs) and provides health insurance coverage to approximately 355,000 individuals with over 100 plans, services, and products. The company specializes in health insurance, pharmacy benefits, Medicare Advantage, and self-funded plans, promoting a culture that emphasizes bringing out the best in its members and staff.

📋 Description

• Apply the six essential case management activities: assessment, planning, implementation, coordination, monitoring, and evaluation • Assess patients’ immediate and long-term medical and social needs • Develop and continuously evaluate individualized plans of care • Monitor quality and effectiveness of care • Ensure regulatory, privacy, payment, reimbursement, and appeal-process compliance • Coordinate decisions and documentation and maintain an accurate database • Build relationships with interdisciplinary teams and communicate case objectives • Advocate for patients and identify potential complications • Apply the Americans with Disabilities Act and relevant federal legislation • Research community resources and establish support systems • Communicate available services and help patients obtain them • Identify and implement alternative care levels and resources • Evaluate quality and cost effectiveness with payors and providers; negotiate discounts when appropriate • Document plans of care timely • Participate in training and education committees • Support, guide, and train support staff • Perform assignments professionally

🎯 Requirements

• Registered Nurse (RN) with active, current, unrestricted license in a Nurse Licensure Compact (NLC) state required • Case Management Certification (CCM) required; candidates without CCM must obtain it within three years of commencing employment • Three years of clinical RN experience in a med/surg or ambulatory care setting required • Clinical experience in Behavior Health, Transplant, Neo-Natal, or Oncology preferred • Previous experience in managed care a plus • Clinical knowledge of health or social work needs for the population served • Ability to identify barriers to successful care management • Ability to interact effectively with physicians and healthcare team members • Excellent problem-solving and time management skills • Excellent written, verbal, and interpersonal communication skills • Ability to complete job duties independently and proficiently • Flexibility in work schedules and assignments • Proven examples of Nova’s Core 4 • Knowledge of multi-state licensure scope of practice • Immigration or work visa sponsorship will not be provided

🏖️ Benefits

• First-class perks and benefits • Scorecard incentive eligibility • Full range of benefits • Generous paid time off • Continuing education opportunities