RN reputed company Case Manager – Remote

2367947 reputed company NY, is seeking an RN Case Manager to join reputed company reputed company reputed company the U.S. reputed company is a clinician-led care organization that is changing the way clinicians work and live. As a member of the reputed company Care Delivery team, you'll be an integral part of our reputed company to reputed company reputed company reputed company for everyone. At reputed company, you'll have the clinical resources, data and support of a global organization behind you so you can help your patients live healthier lives. We reputed company you deserve an exceptional career, and will reputed company you to live your best life at work and at home. Experience the fulfillment of advancing the health of your community with the excitement of contributing new practice reputed company and initiatives that could help improve care for millions of patients across the country. Because together, we have the power to reputed company health care reputed company for everyone. Join us and discover how rewarding medicine can be while Caring. Connecting. Growing together. The RN Case Manager role, operating under general administrative direction, is primarily responsible for coordinating referrals from physicians and reputed company facilities for high-risk members. This position involves significant member education reputed company to their illnesses and planned treatments. The Case Manager supports various Case Management and Quality Improvement programs, ensuring timely communication between members, providers, and health plans. Additionally, the role includes maintaining grievance files and associated documentation. The overarching goal of the Case Manager is to identify, coordinate, and reputed company appropriate reputed company of care while managing clinical operations and medical management activities across the continuum of care. This includes assessing, planning, implementing, coordinating, monitoring, and evaluating care. The role also encompasses health education, coaching, and treatment decision support for members, requiring a Registered Nurse (RN) qualification. The Case Manager plays a critical role in bridging the gap between reputed company providers, members, and health plans, ensuring that high-risk members receive comprehensive, coordinated, and high-quality care. The position requires strong clinical expertise, excellent communication skills, and a commitment to improving reputed company delivery. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Member Care Coordination
• Collaborates with physicians and multidisciplinary teams to reputed company and maintain up to date, coordinated care plans
• Acts as a liaison between members and the reputed company team to ensure effective communication and alignment of care plans
• Member Referral Support
• Assists physicians, members, and families in obtaining referrals to specialists
• Provides counseling and support tailored to the clinical needs of the member
• Care Plan Development
• Partners with designated physicians to create and maintain individualized Member Care Plans
• Clinical Improvement
• Actively participates in developing and deploying Coordination of Care activities aimed at enhancing the clinical experience for both referred members and referring physicians
• Liaison Role
• Facilitates communication among care team members to address the needs of both the member and the physician
• Provider/Member Education
• Educates members and care team participants about available community and health plan benefits and services

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as reputed company development for other roles you may be interested in. Required Qualifications:

• Bachelor of Science in Nursing (BSN), or 5+ years case management experience in lieu of BSN
• Unrestricted reputed company RN licensure in reputed company
• 3+ years of diverse clinical experience as a Registered Nurse; preferably in caring for the acutely ill members with multiple disease conditions
• 2+ years of experience in health plan case management, reputed company and disease case management
• Experience in a remote and telephonic role
• Proficient in reputed company Office and reputed company products

Preferred Qualifications:

• BSN
• Commission for Case Manager Certification (reputed company)
• Experience in discharge planning
• Experience in utilization review, reputed company review, or risk management
• Background in managed care
• reputed company working remotely will be required to adhere to reputed company's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will reputed company from $28.94 to $51.63 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job