Case Manager

This is a fully remote position, open to applicants in Florida, +1 more state.

📋 Description

• Implement the six fundamental case management activities: assessment, planning, implementation, coordination, monitoring, and evaluation.

• Evaluate patients' immediate and long-term social and medical requirements.

• Create and revise patient-centered care plans that take into account physical, psychosocial, benefit plan, and cost-effectiveness considerations.

• Oversee the quality and effectiveness of care, adapting to the evolving needs of patients.

• Ensure compliance with regulatory standards, privacy regulations, payment/reimbursement processes, and appeals procedures.

• Facilitate decision-making, documentation, and maintain a precise database.

• Build relationships with interdisciplinary teams and convey case objectives effectively.

• Advocate for patients while identifying potential complications.

• Apply the Americans with Disabilities Act and pertinent federal legislation.

• Investigate community resources and assist patients in accessing relevant services.

• Identify and implement alternative levels of care and resources, including rehabilitation and home health care.

• Assess quality and cost-effectiveness in collaboration with payors, providers, and team members; negotiate discounts as appropriate.

• Utilize case management, problem-solving, confidentiality, and liability principles.

• Document care plans promptly and analyze outcomes effectively.

• Engage in professional organizations, continuing education, and training committees at Nova.

• Assist with staff orientation and training while providing guidance to support staff.

• Carry out assignments with professionalism and operate within the scope of multi-state licensure.

⛳️ Requirements

• An active, current, unrestricted Registered Nurse (RN) license in a Nurse Licensure Compact (NLC) state is required.

• Case Management Certification (CCM) is mandatory; candidates lacking CCM certification must obtain it within three years of starting employment.

• A minimum of three years of clinical RN experience in a med/surg or ambulatory care environment is required.

• Clinical experience in Behavioral Health, Transplant, Neo-Natal, or Oncology is preferred.

• Previous managed care experience is an advantage.

• Clinical understanding of the health or social work needs for the served population.

• Ability to recognize obstacles to a successful care management pathway.

• Capability to interact effectively with physicians and other healthcare team members.

• Strong problem-solving and time management abilities.

• Exceptional written, verbal, and interpersonal communication skills.

• Competence to perform job responsibilities independently and proficiently.

• Flexibility in work schedules and assignments is essential.

• Demonstrated examples of embodying Nova’s Core 4 values.

• Immigration or work visa sponsorship is not available.

• Candidates must reside in North Carolina or Florida.

• A bachelor’s degree is preferred.

🏝️ Benefits

• Exceptional perks, benefits, and a culture that encourages growth, innovation, and collaboration.

• Eligibility for scorecard incentives.

• Comprehensive range of benefits.

• Generous paid time off.