RN Case Manager

This is a fully remote position, open to applicants in Idaho, +5 more states.

📋 Description

• Evaluate, plan, implement, coordinate, monitor, and assess options and services necessary to address individual health requirements by utilizing plan benefits and community resources.

• Promote cost-effectiveness and implement cost containment strategies.

• Deliver nursing services within the boundaries of licensure and adhere to policies, procedures, regulations, URAC standards, and state laws.

• Utilize evidence-based practices to guarantee compliance, ensure an appropriate level of care, and maintain patient safety.

• Offer specialized education and insight regarding disease-specific conditions.

• Remain informed about medical and surgical techniques, healthcare services, pharmaceuticals, healthcare delivery trends, enterprise protocols, policies, and contracts.

• Act as a liaison between patients, families/caregivers, physicians, hospital discharge planners, home care providers, and ancillary service providers.

• Collaborate proactively with referrals to identify candidates for case management, elucidate services, secure voluntary consent, and manage a minimum patient caseload.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Preferred: Bachelor's degree in Nursing.

• Required: Registered Nurse (RN) with a current active state license in good standing in the state(s) where job responsibilities are performed.

• Case management certification is mandatory; if not acquired prior to employment, must obtain URAC recognized certification within three (3) years of hire as a RN Case Manager.

• Acceptable case management certifications include: Certified Case Manager (CCM), Accredited Case Manager (ACM), and Registered Nurse - Board Certified (RN-BC).

• Minimum of four (4) years of clinical practice experience in areas such as case management, home health, critical care, medical/surgical, discharge planning, concurrent review, or obstetric/neonatal care.

• Ability to work independently.

• Strong attention to detail.

• Opportunity to work remotely from Arkansas, Washington, Oregon, Utah, Idaho, North Dakota, or Minnesota.

• Must comply with security and confidentiality standards and adhere to segregation of duties guidelines.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Flexible work arrangements to support work-life balance.