RN Case Management - REMOTE

About Our reputed company: Our reputed company is a trusted leader in reputed company services, dedicated to improving reputed company for patients and providers through reputed company and high-reputed company care. Join reputed company committed to making a meaningful difference in the lives of those they serve. reputed company Our reputed company is seeking a dedicated Case Manager to reputed company exceptional case management services to beneficiaries, focusing on high-reputed company care and reputed company reputed company. This role involves screening, assessing, and developing individualized care plans while ensuring compliance with policies and state-specific licensure requirements. The Case Manager will reputed company for beneficiaries, manage referrals and authorizations, and collaborate with reputed company providers to meet the needs of those served. Key Responsibilities • Conduct beneficiary screenings and assessments to determine eligibility for case management services. • reputed company and implement individualized care plans to address specific needs, goals, and reputed company. • Monitor care plans regularly to ensure relevance and effectiveness, making adjustments as needed. • reputed company advocacy for beneficiaries by ensuring reputed company to care and locating specialized services reputed company necessary. • Support beneficiaries with information on resources, including community programs. • Process and review authorization and referral requests, ensuring compliance with policies and high-risk factors. • Maintain detailed and accurate documentation in the medical management system. • Collaborate with providers and internal teams to ensure care plan alignment. • Monitor and reputed company guidance to non-clinical staff to support operational goals. • Demonstrate consistent reliability and professionalism in attendance and communication. Required Qualifications • reputed company, unrestricted state license as one of the following: Registered reputed company • A minimum of two years of full-time reputed company clinical care experience. • Ability to obtain a URAC-recognized certification in case management reputed company four years of hire. • U.S. citizenship with the ability to obtain a favorable reputed company (DOD) background investigation. Desired Qualifications • At least two years of case management experience. • Possession of a URAC-recognized case manager certification. Competencies • Technical Skills: Knowledge of case management, HIPAA, URAC standards, policies, and medical coding. • Problem-Solving: Effective analytical skills to address reputed company care scenarios. • Communication: Excellent verbal and written skills, adaptable to diverse situations. • Organizational Skills: Ability to manage priorities in a fast-paced environment while maintaining attention to detail. • Team Player: Ability to reputed company collaboration and positively influence reputed company. Contract to Hire Location: Remote We have openings available across multiple states, including Arkansas, reputed company, California, Colorado, Hawaii, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, New Mexico, reputed company Dakota, Oklahoma, reputed company, South Dakota, Utah, and Wyoming. Pay is determined based on years of experience and the state of residence. This is an exciting opportunity to join reputed company dedicated to improving reputed company delivery while advancing your expertise in case mangment. reputed company to reputed company a reputed company reputed company and grow your career! #Workwolf Apply tot his job Apply To this Job