Case Manager – NLC

This is a fully remote position, open to applicants in Arizona, +2 more states.

📋 Description

• Execute assessment, planning, implementation, coordination, monitoring, and evaluation activities in case management.

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

• Create personalized care plans that take into account physical and psychosocial needs, benefit plans, and cost-effectiveness.

• Review and oversee care plans, quality of care, and service efficacy.

• Ensure compliance with regulatory standards and privacy laws, manage reimbursement and appeals processes, and maintain accurate documentation and databases.

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

• Serve as a patient advocate and recognize potential complications.

• Implement the Americans with Disabilities Act along with pertinent federal legislation.

• Investigate and coordinate community resources, assistive devices, and support systems.

• Communicate available services and resources, aiding patients in accessing them.

• Identify and apply alternative levels of care, providers, and resources.

• Assess cost-effectiveness, collaborate with payors and providers, and negotiate discounts when suitable.

• Promptly document patient care plans.

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

• Assist in staff orientation, training, and development.

• Offer guidance and support to team members.

• Carry out assignments with professionalism.

⛳️ Requirements

• Currently licensed Registered Nurse (RN) with an active, unrestricted license in a Nurse Licensure Compact (NLC) state is required.

• A Bachelor’s degree is preferred.

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

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

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

• Previous managed care experience is advantageous.

• Strong clinical knowledge of the health or social work needs of the patient population served.

• Capability to identify obstacles to successful care management.

• Ability to interact effectively with physicians and other healthcare professionals.

• Outstanding problem-solving and time management abilities.

• Excellent written, verbal, and interpersonal communication skills.

• Proficiency in completing job responsibilities independently.

• Flexibility in work schedules and assignments is essential.

• Immigration or work visa sponsorship is not available.

• Candidates must reside in Arizona, North Carolina, or Florida.

• Must comprehend the scope of practice for multi-state licensure and practice accordingly.

🏝️ Benefits

• Potential availability of scorecard incentives.

• Comprehensive benefits package.

• Generous paid time off.

• Opportunities for continuing education participation.

• Access to training and educational opportunities.