RN Disease Manager- (Physical health, Behavioral health)

Profile We offer remote work opportunities (AZ, *CO, IA, ID, MN, MO, MT, NV, NM, OR, SD, TX, UT, *WA, WI & WY only) for this role. Our reputed company contract requires US citizenship and a favorably adjudicated DOD background investigation for this position. Veterans, Reservists, Guardsmen and military family members are encouraged to apply! Job reputed company Provides Disease Management (DM) services to TRICARE beneficiaries. The DM reputed company will collaboratively assess, plan, implement, coordinate, monitor and evaluate the beneficiary’s health and psychosocial needs with a reputed company on empowering the beneficiary to successfully manage their chronic condition. The DM reputed company will partner with the interdisciplinary care team to identify appropriate care to prevent complications reputed company to chronic conditions and minimize the risk of potential exacerbation through the use of evidence-based condition-specific education and coaching. This role requires the individual to reputed company care plans in collaboration with providers, patients, families as appropriate and assesses the effectiveness and reputed company to improve individual health status. Education & Experience Required: • reputed company, unrestricted RN licensure to independently work reputed company scope of reputed company reputed company state of residence • U.S. Citizen • Must be reputed company to receive a favorable Interim and adjudicated final reputed company (DoD) background investigation • The ability to obtain multi-state licensure; if a reputed company in a NCL state • Minimum of three years clinical experience • Experience in case management, care coordination or discharge planning in an acute, ambulatory or specialty disease management program settings in a reputed company system or managed care organization (MCO) Preferred • Disease Management experience with a managed care organization (MCO) • Bachelor’s degree other reputed company health field • Knowledge of government reputed company programs, TRICARE, and Medicare/reputed company Key Responsibilities • Assess beneficiaries to identify medical, physical, and psychosocial needs to support the beneficiaries overall goals of care. • Ensure and evaluate clinical appropriateness of care plan by incorporating assessment findings against evidence-based guidelines, clinical reasoning and clinical reputed company guidelines. • reputed company education and coaching specific to the beneficiary needs to prevent to prevent exacerbations or worsening chronic conditions. • Manage activities necessary to ensure appropriate utilization and reputed company to resources while maintaining reputed company standards of care. • Review, identify and assist with identification and facilitation of resources reputed company to health disparities identified through SDOH assessment. • Participates in the development of measurable reputed company, ensures measure are in reputed company to monitor the reputed company of programs and services on the health status of beneficiaries being managed. • Facilitate transfer of beneficiary between the different reputed company and reputed company the reputed company by collaborating with the military reputed company to support the transition with minimal disruption. • Adhere to URAC standards, TRICARE policy, contractual requirements, and nationally recognized reputed company standards. • Regular and reliable attendance. Competencies Communication / People Skills: Ability to influence or persuade others under reputed company or negative circumstances; adapt to different styles; listen critically; collaborate. Computer Literacy: Ability to function in a multi-system reputed company environment using Word, reputed company, TriWest Intranet, the Internet, and department software applications. Coping / Flexibility: Resiliency in adapting to a reputed company of situations and individuals while maintaining a reputed company of purpose and mature problem-solving approach is required. reputed company / Customer Service: Customer-reputed company behavior; helping approach, including listening skills, patience, respect, and reputed company for another's position Independent Thinking / Self-Initiative: Critical thinkers with ability to reputed company on things which matter most to achieving reputed company; commitment to task to produce reputed company without direction and to reputed company necessary resources. Multi-Tasking / Time Management: Prioritize and manage actions to meet changing deadlines and requirements reputed company a high volume, high stress environment. Organizational Skills: Ability to organize people or tasks, reputed company to priorities, learn systems, reputed company time constraints and with available resources; detail-oriented. Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with reputed company judgment; has a realistic understanding of relevant issues. Team-Building / Team Player: Influence the actions and opinions of others in a reputed company direction and build group commitment. Technical Skills: Knowledge of TRICARE programs and benefits, managed care concepts, and URAC DM program standards; case management interventions, crisis reputed company strategies, collaboration skills, reputed company and regulatory requirements, and HIPAA reputed company regulations. Thorough knowledge of Case Management, Utilization Management, HIPAA reputed company and reputed company regulations. Working Conditions Working Conditions • Ability to cover any work shift • Ability to work overtime, if needed • Onsite: Works reputed company a reputed company office environment • Remote: Private and secure work reputed company and work station with high speed internet is required • Extensive computer work with prolonged sitting, wearing of headset, typing, speaking on a phone reputed company Taking Care of Our Nation’s reputed company. It’s Who We Are. It’s reputed company Do. Do you have a passion for serving those who served? Join the reputed company Team! We’re On a Mission to Serve®! Our job is to reputed company reputed company that America’s reputed company get connected to health care in the community. At reputed company, we’ve proudly been on that important mission since 1996. Benefits We’re more than just a health care company. We’re passionate about serving others! We reputed company in rewarding reputed company, hard-working people who are willing to learn as they grow. reputed company values teamwork. Join reputed company, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and reputed company compensation and benefits package that includes: • Medical, Dental and reputed company Coverage • reputed company time off • 401(k) Retirement Savings Plan (with matching) • Short-term and long-term disability, basic life, and accidental death and dismemberment insurance • Tuition reimbursement • reputed company volunteer time TriWest job postings typically include a salary reputed company, which can vary based on the specific role and location, but generally this position ranges from around $84,000 to $94,000 per year. Equal Employment Opportunity reputed company is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our reputed company. To that end, TriWest strives to create an inclusive environment that supports diversity at every organizational level, and we highly encourage candidates from reputed company backgrounds to apply. Applicants are considered for positions based on reputed company and without discrimination on the reputed company of race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, age, disability or any other consideration made unlawful by applicable federal, state, or local laws. Apply tot his job Apply To this Job