Job Description:
• Delivering comprehensive case management services through telephonic and/or face-to-face interactions
• Assessing, planning, implementing, and coordinating care strategies to support members' medical needs and promote overall wellness
• Utilizing clinical judgment and data-driven tools to evaluate member eligibility, identify health risks, and develop proactive care plans
• Conducting holistic assessments that consider co-morbid conditions, functional limitations, and social determinants of health
• Reviewing prior claims, evaluating work capacity, and determining the need for referrals to clinical resources
• Collaborating with supervisors and multidisciplinary teams to overcome barriers and optimize care planning
• Operating within established regulatory and organizational policies, applying case management processes and service strategies
Requirements:
• An active and unrestricted RN license in the state of residence
• Willing and able to obtain additional state licenses upon hire (Paid for by the company)
• 3+ years' experience of acute care and/or case management
• 2+ years' Med/Surg experience
• Must be willing to work Mon-Fri 8-430 PST time zone
• Behavioral Health experience preferred
• Certified Case Manager preferred
• Managed care experience preferred
• Strong telephonic communication skills
• Ability to manage multiple priorities, effective organizational, and time management skills
• Ability to use a computer station and sit for extended periods of time
Benefits:
• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility