Case Manager

This is a fully remote position, open to applicants in Kentucky, +6 more states.

📋 Description

• Coordinate care, resources, and services for designated member populations.

• Provide direction and promote the effective utilization and oversight of healthcare resources.

• Collaborate with members of the healthcare team to achieve optimal clinical and resource outcomes.

• Participate in a multidisciplinary team to coordinate member care and services.

• Conduct comprehensive assessments and collaborate on treatment, intervention, and discharge planning.

• Create member-centric plans customized to individual needs, health status, education, and support requirements.

• Identify obstacles to achieving goals or implementing the care plan.

• Leverage community resources and funding sources.

• Monitor and manage members through follow-up, education, referrals, documentation, and plan adjustments.

• Assess and facilitate care across various settings, including physician offices, hospitals, rehabilitation units, skilled nursing facilities, and home care.

• Educate members and promote proactive interventions.

• Document assessments, planning, implementation, monitoring, and outcomes.

• Conduct outreach to high-risk, high-cost, or high-utilization members.

• Review alternative treatment plans and evaluate benefits exceptions or flexible benefit options.

• Assess the medical necessity and appropriateness of services.

• Develop policies, procedures, education, or training as necessary.

⛳️ Requirements

• Registered Nurse (RN) with a minimum of 3 years of clinical and/or case management experience is required.

• Must possess and maintain a valid and applicable clinical license (NC or compact multi-state licensure).

• Certified Case Manager (CCM) certification must be obtained within 2 years of employment.

• Case management experience is highly preferred.

• Experience in maternal health or pediatrics nursing is a plus.

• Familiarity with electronic medical records (EMR) is preferred.

• Strong technical aptitude and quick adaptability to new systems are essential.

• Certified Case Manager (CCM) certification is preferred.

🏝️ Benefits

• Work-life balance, flexibility, and autonomy.

• Medical, dental, and vision coverage.

• Health and wellness programs.

• Parental leave and support.

• Assistance for adoption and surrogacy.

• Career development programs.

• Tuition reimbursement for further education.

• 401(k) matching, including an annual company contribution.

• Paid Time Off (PTO).

• Annual Incentive Bonus based on corporate goal achievement and individual performance.

• Remote work option with occasional in-office visits each year for significant moments that matter.