Large Case Manager, RN

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

📋 Description

• Deliver comprehensive, appropriate, and proactive case management services both onsite and via telephone.

• Advocate for high-quality, suitable, and cost-effective healthcare solutions for plan participants dealing with chronic or catastrophic conditions.

• Execute all stages of the case management process under the guidance and oversight of a Certified Case Management Professional.

• Clarify the role and extent of services to patients.

• Inform patients that the information collected will be shared with the payer and secure consent for case management activities.

• Evaluate individual medical and psychosocial needs.

• Identify challenges that may hinder quality, cost-effective care.

• Develop personalized action plans, establish measurable objectives, and create contingency strategies.

• Empower patients to make informed choices and enhance communication with the healthcare team.

• Discuss advance directives when applicable.

• Secure agreement on plans from patients, families, payers, and providers.

• Refer patients to qualified, high-quality healthcare providers.

• Continuously assess plans for effectiveness, satisfaction, cost-efficiency, compliance, and impact on quality of life.

• Adjust plans as medical conditions, family dynamics, or insurance coverage evolve.

• Maintain timely, organized, objective, factual, clear, and concise documentation of cases.

• Uphold ethical standards as a patient advocate while adhering to case management principles, policies, standards, and guidelines.

• Engage as early as possible following the onset of illness or injury and maintain involvement throughout the process.

⛳️ Requirements

• Must be a Registered Nurse with at least 5 years of clinical experience.

• Possession of credentials such as CCM/CRRN, OCN, or other relevant certifications is preferred.

• Exceptional written, verbal, and computer skills are essential.

• A positive, proactive, and team-oriented attitude is crucial.

• Strong time management and organizational abilities are required.

• Must be adaptable and capable of working independently.

• Active and unrestricted multi-state nursing license is necessary.

• Recent clinical experience is required.

• Experience in Behavioral Health is preferred.

🏝️ Benefits

• Competitive salary and benefits package.

• Opportunities for professional development and continuing education.

• Supportive work environment with a focus on teamwork.

• Flexible working arrangements to promote work-life balance.