Nurse Case Manager I

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

📋 Description

• Manage care for members with complex and chronic health needs within the boundaries of your licensure.

• Evaluate, develop, implement, coordinate, monitor, and assess care plans throughout the care continuum.

• Execute responsibilities via telephone or in-person, including planning for hospital discharges.

• Ensure members have access to services that align with their health requirements.

• Conduct assessments to identify individual needs and establish care management goals.

• Facilitate authorizations and referrals within the benefits framework or through additional contractual agreements.

• Coordinate both internal and external resources to address identified needs.

• Monitor and assess the effectiveness of care plans and make necessary adjustments.

• Collaborate with Medical Directors and Physician Advisors regarding care management treatment strategies.

• Negotiate reimbursement rates when applicable.

• Aid in resolving provider, claims, or service-related issues.

⛳️ Requirements

• A BA/BS in a health-related discipline and a minimum of 3 years of clinical experience; or a combination of education and experience that provides a comparable background.

• A current, unrestricted RN license in the relevant state(s) is mandatory.

• Multi-state licensure is required if services are provided in multiple states.

• Certification as a Case Manager is preferred.

• Having both a Case Manager certification and a BS in a health or human services-related field is preferred.

• Candidates should live within a reasonable commuting distance from the job location(s), unless a legal accommodation is provided.

• COVID-19 and Influenza vaccinations are mandatory for specific patient/member-facing positions unless a valid reason is presented.

🏝️ Benefits

• Comprehensive benefits package.

• Incentive and recognition programs.

• Equity stock purchase options.

• 401k contributions.

• Opportunities for merit increases.

• Paid holidays.

• Paid Time Off.

• Incentive bonus programs.

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Short-term disability coverage.

• Long-term disability coverage.

• 401(k) matching.

• Stock purchase plans.

• Life insurance.

• Wellness initiatives.

• Financial education resources.

• Flexibility for virtual work.

• Required in-person training sessions.

• Opportunities for professional and personal development.