Registered Nurse Case Manager

Summary The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license (compact license required) Duties Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate administration of benefits Education RN with current unrestricted compact state licensure. Case Management Certification CCM preferred Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures Experience 3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. Healthcare and/or managed care industry experience. Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Typical office working environment with productivity and quality expectations? Woking Hours Monday - Friday 8:00 a.m. to 5:00 p.m. CST Job Types: Full-time, Contract Pay: Up to $32.61 per hour People with a criminal record are encouraged to apply Application Question(s): • 1. Must have a compact license. 2. they must reside in the CST time zone. But will consider EST if candidate is exceptional. Experience: • Case management: 1 year (Required) License/Certification: • Nurse Licensure Compact (NLC) (Required) Work Location: Remote Apply tot his job