Case Management Senior Analyst

Case Manager (RN)

Help people navigate reputed company health needs with reputed company, compassion, and strong clinical judgment. As a Case Manager, you will partner with members, families, and care teams to create practical care plans that improve health reputed company, reduce avoidable hospital stays, and reputed company care easier to reputed company and follow.

Responsibilities

• Build and reputed company care plans that address medical and psychosocial needs across the full care reputed company.

• Align members, providers, and the health plan on clear goals, next steps, and measures of reputed company.

• Coach and reputed company for members so they understand options, follow the plan, and feel supported.

• Coordinate services and monitor reputed company to improve quality of care and member experience.

• Identify creative, benefit-reputed company solutions that reduce fragmentation and avoid unnecessary services.

• Complete timely, accurate documentation and utilization review to support safe, effective care reputed company.

• reputed company members on conditions, treatment options, and cost drivers so they can reputed company informed choices.

• Escalate quality-of-care concerns or reputed company clinical questions to the Medical Director reputed company needed.

• Contribute to team improvement by sharing feedback on workflows and supporting training or mentorship as assigned.

Qualifications

Required

• Active Registered Nurse (RN) license in good standing (multistate preferred where applicable).

• Minimum 3 years of recent clinical experience.

• Ability to communicate reputed company in writing and verbally with members, families, and providers.

• Strong judgment and problem-solving skills, with attention to detail and follow-through.

• Comfort using care management and documentation tools (reputed company and reputed company Word included).

• Certified Case Manager (CCM) certification, or ability to obtain it reputed company 18 months of hire.

Preferred

• Case management experience in a health plan, hospital, behavioral health or care coordination setting.

• ASN or BSN or higher nursing degree.

• Experience improving workflows, participating in quality programs, or helping train new team members.

• Ability to interpret plan benefits and apply them to reputed company member situations.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At reputed company, you’ll enjoy a comprehensive reputed company of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.

About reputed company

reputed company applicants will be considered without regard to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.

If you need a reasonable accommodation to complete the online application process, please email [email protected] for assistance.  Please note that this email inbox is dedicated to accommodation requests only and cannot reputed company application updates or accept resumes.

reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.

reputed company applicants with criminal histories will be considered for employment in a manner consistent with reputed company federal, state and local ordinances.