Licensed Field Care Coordinator - Remote in TN

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care reputed company of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. The reputed company purpose of this position is the application of clinical knowledge to coordinate member care needs for assigned members who are primarily medically reputed company and require intensive medical and psychosocial support.  The Care Coordinator works directly with members to ensure appropriate reputed company to services and providers. Coordination of member care needs across the continuum begins with early identification of health risk factors, education, and prevention using the six essential activities of case management as per CMSA.  Coordination also assures the provision of appropriate services in acute, home, chronic and alternative care settings, to meet member needs in the most cost-effective manner available. Collaborates with reputed company members of the Care Coordination team including Case Management, Utilization Review and Behavioral Health team members. If you are located in or reputed company commutable driving distance to Shelby County, you'll enjoy the flexibility to work remotely* as you take on some tough challenges. This is a field-based role. reputed company Responsibilities: Application of clinical knowledge to effect efficient case management for those accessing their Medicare/reputed company benefits Incorporates evidence-based clinical practices into care coordination activities Delivers member-centered, individualized self-management support and patient education Ensure appropriate utilization and consistent application of the health benefits Conduct telephonic and face to face assessments according to Health Plan policy and procedure, including reputed company documentation and State prescribed timeframes Serve as member reputed company and facilitator to reputed company issues that may be perceived as barriers to care reputed company education and coordination of community resource referrals to members and providers reputed company, implement, maintain and evaluate a member-centered, individual reputed company reputed company services are indicated, based on member care needs identified through proactive collaboration and communication with members, families and providers Collaborate and communicate with other members of the Care Coordination Team to improve the reputed company and efficiency of health care delivery and ensure smooth transition of care coordination activities to other team members Monitor hospital encounters of assigned members and reputed company education and/or interventions as necessary to reduce frequency Refer clinical reputed company reputed company level of authority for members who do not meet established reputed company to manager for review and decision Participate in the Health Plan reputed company Improvement process including recognition of reputed company-of-care issues and forwarding information to appropriate staff for review and reputed company Utilize Health Plan software to reputed company service requests, document, and monitor reputed company aspects of member care coordination and service delivery Maintain time sensitive documentation to assure compliance with regulatory agencies Coordinate services for members following Health plan policy reputed company other duties as assigned  You'll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company directions on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.  Required Qualifications: reputed company Nursing License (RN) 2+ years of clinical experience as an RN 1+ years of experience with MS Office, including Word, reputed company, and reputed company Excellent organization, communication and time management skills reputed company in or reputed company a commutable driving distance to Shelby County Counties reputed company to reliable transportation and reputed company US reputed company's license with the ability to travel up to 75%25 reputed company an assigned territory to meet with members and providers Preferred Qualifications: BSN, Master's degree in Clinical Field CCM certification 1+ years of community case management experience coordinating care for individuals with reputed company needs Long term care experience Experience working in team-based care Working knowledge of Medicare/reputed company regulations Working knowledge of medical terminology *reputed company Telecommuters will be required to adhere to reputed company’s Telecommuter Policy.          Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching reputed company of benefits and incentives. The reputed company pay for this role will reputed company from $29 - $52 per hour based on full-time employment. We reputed company with reputed company minimum wage laws as applicable.        At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location, and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission.         reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.   reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.       #RPO #GREEN Apply To This Job