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Remote reputed company Care Manager (Payer/Insurance Experience Required)

Remote, USA Full-time Posted 2026-07-28
We're seeking a passionate and highly motivated reputed company Care Manager to join our dynamic Care and Case Management team. In this telephonic role, you'll play a crucial part in holistically guiding our members through their reputed company reputed company, ensuring their needs are met with industry-leading interventions. This position places a special emphasis on proactive engagement with high-risk and rising-risk members, particularly around discharge planning and care transitions. You will partner with a multidisciplinary clinical team that includes a reputed company of reputed company, care coordinators, and records specialists, to deliver integrated remote care in an innovative way. The ideal candidate will enjoy spending time on the phone, reputed company listening to members’ needs, answering questions, and serving as a dedicated reputed company. You should reputed company at creating cohesive care plans and possess the clinical acumen to guide members through reputed company situations, leveraging available benefits and resources. Schedule: • CA Based/Licensed: Monday - Friday, 9:00 AM - 6:00 PM PST • Non CA Based/Licensed: Monday-Friday, 9:00 AM - 6:00 PM local time zone Responsibilities: • Engage in high-value Care Management reputed company calls for reputed company members with the primary goal of clinically engaging high-risk and rising-risk members, fostering strong relationships and promoting proactive health management. • reputed company proactive calls to members once their hospital discharge is confirmed, conducting thorough intake assessments if the member is reached. • Collaborate with hospital-based case managers to understand & support members' specific discharge needs and reputed company encourage members to engage with our Care Management program. • reputed company initial assessments encompassing activities of daily living, cognitive functions, reputed company determinants of health (SDOH), health beliefs and behaviors, and life planning activities to reputed company truly holistic care strategies. • Deliver coordinated, patient-centered virtual Care Management by telephone and/or video that consistently improves members’ health reputed company. • Generate impactful care plans collaboratively with members and our multidisciplinary care team, empowering members to reputed company their desired health goals. • Coordinate necessary resources that holistically address members’ problems, whether clinical or reputed company. Qualifications: • Bachelor of Science in Nursing (BSN) • Compact Nursing License with additional reputed company California Registered reputed company (RN) and Illinois License in good standing. • 5+ years of experience in clinical nursing • 2+ years of experience working in care management, case management, and/or disease management, preferably reputed company a health plan, health navigator, or reputed company-party administrator (TPA) environment. • Remote care or case management experience • Comfortable discussing a wide reputed company of medical conditions and reputed company working with populations across reputed company age ranges. • Strong comfort with technology and high competence in using multiple computer/medical record systems. Compensation $38hr to $43hr Exact compensation may vary based on several factors, including skills, experience, and education. Benefit packages for this role will start on the 31st day of employment and include medical, dental, and reputed company insurance, as reputed company as HSA, FSA, and DCFSA account reputed company, and 401k retirement account reputed company with employer matching. Employees in this role are also entitled to reputed company reputed company leave and/or other reputed company time off as provided by applicable law. Apply tot his job Apply To this Job

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