Nurse Case Manager I

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

📋 Description

• Conduct care management within the limits of licensure for members with intricate and chronic healthcare requirements.

• Evaluate members and create, execute, coordinate, supervise, and assess care plans.

• Enhance member healthcare throughout the entire care continuum.

• Guarantee member access to services that align with their health needs.

• Manage authorizations and referrals within the benefit framework or through additional contractual arrangements.

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

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

• Negotiate reimbursement rates when applicable.

• Assist in resolving issues related to providers, claims, or services.

• Carry out duties either via telephone or on-site, including planning for hospital discharges.

⛳️ Requirements

• Bachelor’s degree in a health-related field and a minimum of 3 years of clinical experience, or a combination of education and experience that provides a comparable background.

• Current, unrestricted, and active RN license in the relevant state(s).

• Multi-state licensure is necessary when delivering services across various states.

• Certification as a Case Manager is preferred.

• A Bachelor’s degree in a health or human services-related field is preferred.

• Four years of experience in Oncology is preferred.

• Availability from Monday to Friday, 8:30 am to 5:00 pm CST.

• Candidates must live within a reasonable commuting distance from the posting location(s), unless accommodations are granted as mandated by law.

• New candidates in specific patient/member-facing roles must be vaccinated against COVID-19 and Influenza unless a valid exemption is provided.

🏝️ Benefits

• $3,000 sign-on bonus.

• Opportunities for merit increases.

• Paid holidays.

• Paid Time Off.

• Incentive bonus programs.

• Medical, dental, and vision benefits.

• Short- and long-term disability benefits.

• 401(k) plan with company match.

• Stock purchase plan.

• Life insurance coverage.

• Wellness programs.

• Financial education resources.

• Virtual full-time work, except for mandatory in-person training sessions.

• Flexible autonomy and work-life integration.