Case Manager RN

Position Summary

This Case Manager RN position is 100% remote, no travel is expected with this position.

Normal Working Hours: Monday through Friday, 8 hour shift between 8am to 5:30pm Arizona time

The Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members from our Federal Plans. The Case Manager is responsible to evaluate the medical needs of the member in order to facilitate and promote the member's overall wellness. The Case Manager develops a proactive course of action to address issues presented to enhance the member's short and long term outcomes.

• Apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs.
• Conduct comprehensive clinical assessments.
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services.
• Advocate for patients to the full extent of existing health care coverage.
• Promote quality, cost effective outcomes, and make suggestions to improve program/operational efficiency.
• Identify and escalate quality of care issues through established channels.
• Provide an expected very high level of customer service.
• Utilize assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change.
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.

Required Qualifications

• Must have active, current and unrestricted RN licensure in state of residence and have the ability to be licensed in all non-compact states.
• Must be willing and able to work Monday through Friday, 8 hour shift between 8am to 5:30pm Arizona time
• Must live in either PST, MST, or Arizona Time zones
• 3+ years of clinical practice experience required
• 1+ years of experience utilizing MS Office suites

Preferred Qualifications

• Case management experience preferred
• Case Manager Certification

Education

Associate's degree required

BSN preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is

$54,095.00 - $129,615.00