Care Manager RN (Pittsburgh, Philadelphia, Lehigh Valley)
About the position
Responsibilities
• Act as a liaison with members, families, employers, providers, and insurance companies.
• Implement and coordinate case management activities for catastrophic cases and chronically ill members.
• Interact with members telephonically or in person, including home visits.
• Assess and analyze members' medical and vocational status to develop care plans.
• Communicate with stakeholders regarding care and treatment options.
• Prepare documentation of case work activities as required.
• Consult with internal multidisciplinary teams to maximize health outcomes.
• Outreach to treating physicians or specialists as needed.
• Provide educational and prevention information for optimal medical outcomes.
• Apply relevant laws and regulations in the provision of rehabilitation services.
• Testify as required to substantiate case work or reports.
• Evaluate members' needs and benefit plan eligibility using clinical tools.
• Facilitate condition management and optimize wellness and medical outcomes.
• Monitor member progress toward desired outcomes through assessment and evaluation.
Requirements
• Active, current, and unrestricted RN licensure in NY and/or Compact RN licensure in Pennsylvania.
• Minimum 3+ years of clinical practical experience, preferably with Medicare members.
• Minimum 2+ years of case management, discharge planning, or home health care coordination experience.
• Willingness to work Monday through Friday, 8am to 5pm EST, with some flexibility.
• Ability to travel up to 75% for field visits in specified areas.
• 1+ years of experience with MS Office Suites.
Nice-to-haves
• Excellent analytical and problem-solving skills.
• Effective communication, organizational, and interpersonal skills.
• Ability to work independently, potentially from home.
• Proficiency with standard corporate software applications.
• Efficient computer skills, including navigating multiple systems.
• Willingness to obtain multi-state RN licenses if needed.
• Bilingual in Spanish preferred.
• Certified Case Manager certification preferred.
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred.
Benefits
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Well-being programs and education assistance.
• Free development courses.
• CVS store discount and discount programs with partners.
• Paid Time Off (PTO) and paid holidays.
Apply Now
Apply Now
Responsibilities
• Act as a liaison with members, families, employers, providers, and insurance companies.
• Implement and coordinate case management activities for catastrophic cases and chronically ill members.
• Interact with members telephonically or in person, including home visits.
• Assess and analyze members' medical and vocational status to develop care plans.
• Communicate with stakeholders regarding care and treatment options.
• Prepare documentation of case work activities as required.
• Consult with internal multidisciplinary teams to maximize health outcomes.
• Outreach to treating physicians or specialists as needed.
• Provide educational and prevention information for optimal medical outcomes.
• Apply relevant laws and regulations in the provision of rehabilitation services.
• Testify as required to substantiate case work or reports.
• Evaluate members' needs and benefit plan eligibility using clinical tools.
• Facilitate condition management and optimize wellness and medical outcomes.
• Monitor member progress toward desired outcomes through assessment and evaluation.
Requirements
• Active, current, and unrestricted RN licensure in NY and/or Compact RN licensure in Pennsylvania.
• Minimum 3+ years of clinical practical experience, preferably with Medicare members.
• Minimum 2+ years of case management, discharge planning, or home health care coordination experience.
• Willingness to work Monday through Friday, 8am to 5pm EST, with some flexibility.
• Ability to travel up to 75% for field visits in specified areas.
• 1+ years of experience with MS Office Suites.
Nice-to-haves
• Excellent analytical and problem-solving skills.
• Effective communication, organizational, and interpersonal skills.
• Ability to work independently, potentially from home.
• Proficiency with standard corporate software applications.
• Efficient computer skills, including navigating multiple systems.
• Willingness to obtain multi-state RN licenses if needed.
• Bilingual in Spanish preferred.
• Certified Case Manager certification preferred.
• Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) preferred.
Benefits
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Well-being programs and education assistance.
• Free development courses.
• CVS store discount and discount programs with partners.
• Paid Time Off (PTO) and paid holidays.
Apply Now
Apply Now