Case Manager, Registered Nurse

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

📋 Description

• Evaluating the health status and care coordination requirements of members.

• Conducting inpatient reviews and planning for discharges.

• Creating and executing the Care Management (CM) plan.

• Monitoring and assessing the CM plan, involving the Medical Director as necessary.

• Appropriately closing cases when members have satisfied discharge criteria.

• Performing thorough clinical assessments.

• Analyzing needs and developing adaptable strategies based on members' requirements, benefit plans, or external programs/services.

• Advocating for patients to the fullest extent of available health care coverage.

• Encouraging quality, cost-effective outcomes and suggesting improvements for program and operational efficiency.

• Identifying and escalating quality of care concerns through established channels.

• Employing assessment techniques to evaluate members’ health literacy, technology proficiency, and readiness for change.

• Utilizing influencing and motivational interviewing techniques to maximize member engagement and encourage lifestyle changes for optimal health.

• Providing coaching, information, education, and support to empower members in making independent medical and healthy lifestyle choices.

⛳️ Requirements

• Active, current, and unrestricted RN license in the state of residence.

• Willingness and capability to obtain additional state licenses upon hiring.

• A minimum of 3 years of clinical experience as an RN.

• Compact RN licensure is preferred.

• Ability to exercise independent and sound judgment.

• Strong decision-making capabilities.

• Well-developed interpersonal skills.

• Capacity to manage multiple priorities effectively.

• Proficient organizational and time management skills.

• Strong teamwork abilities.

• Managed care experience is preferred.

• Competent computer skills.

🏝️ Benefits

• Medical, dental, and vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources, based on eligibility.