Case Manager

This is a fully remote position, open to applicants in United States.

📋 Description

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

• Evaluate both immediate and long-term medical and social needs of patients.

• Create and continually assess personalized care plans.

• Oversee the quality and effectiveness of care provided.

• Ensure compliance with regulations, privacy, payment, reimbursement, and appeal processes.

• Coordinate decisions, documentation, and maintain an accurate database.

• Foster relationships with interdisciplinary teams and communicate case objectives effectively.

• Advocate for patients while identifying potential complications.

• Apply the Americans with Disabilities Act and relevant federal legislation appropriately.

• Investigate community resources and establish supportive systems.

• Inform patients about available services and assist them in accessing these resources.

• Recognize and implement alternative levels of care and resources as needed.

• Assess quality and cost-effectiveness with payors and providers, negotiating discounts when warranted.

• Document care plans in a timely manner.

• Engage in training and educational committees.

• Provide support, guidance, and training to support staff.

• Execute assignments in a professional manner.

⛳️ Requirements

• Must be a Registered Nurse (RN) with an active, current, unrestricted license in a Nurse Licensure Compact (NLC) state.

• Case Management Certification (CCM) is required; candidates lacking CCM 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 setting is required.

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

• Previous managed care experience is a plus.

• Possess clinical knowledge of health or social work needs for the population served.

• Ability to recognize barriers to effective care management.

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

• Strong problem-solving and time management skills are essential.

• Excellent written, verbal, and interpersonal communication skills are required.

• Ability to perform job duties independently and proficiently.

• Flexibility in work schedules and assignments is necessary.

• Demonstrated examples of Nova’s Core 4 are expected.

• Knowledge of multi-state licensure scope of practice is required.

• Immigration or work visa sponsorship will not be provided.

🏝️ Benefits

• Comprehensive perks and benefits package.

• Eligibility for scorecard incentives.

• Full range of benefits offered.

• Generous paid time off.

• Opportunities for continuing education.