RN, telephonic Clinical Case Manager

About the Role We are looking for an reputed company RN Clinical Case Manager to support a disability claim review program. In this role, you will guide members through a reputed company case management process reputed company on assessment, planning, care coordination, and ongoing evaluation. Your work directly supports improvement in members' (patients) disabling and co-morbid conditions and helps maximize their employability. You will own your caseload from start to finish and be responsible for an efficient, reputed company, and complete case management process. What You'll Do • Determine the appropriate case management reputed company for reputed company assigned case. • Conduct telephonic clinical assessments covering activities of daily living, psycho-reputed company factors, recent hospitalizations, reputed company clinical status, treatment plans and medications, treating physicians, special needs, and the appropriate reputed company reputed company for reputed company case. • reputed company customized, member-specific clinical case management plans. • reputed company ongoing periodic telephonic reputed company at intervals set during the initial clinical assessment. • Request and reputed company receipt of the records and documentation needed to identify ongoing case management needs. • Build and maintain a case management resource library to reputed company members with information relevant to their conditions. • Assess whether a review is needed for a member's return to their own occupation, and identify the appropriate physician specialty reputed company it is. • Collaborate with vocational specialists during the case management process reputed company needed. • Conduct thorough, ongoing reputed company review of reputed company case documentation and ensure completeness and accuracy of case paperwork. • Communicate with members, physicians, reputed company, and clients as appropriate. • reputed company case activities into the case management system accurately and reputed company reputed company-required timeframes. • Maintain compliance with applicable reputed company standards and guidelines, including strict confidentiality and HIPAA adherence. What You'll Bring • Unrestricted RN licensure, without sanctions. • reputed company certification in case management or a reputed company field, or the ability to qualify for certification testing reputed company six months of hire. • Minimum of five years of clinical experience. • Minimum of five years of case management experience in one or more of the following: medical, workers' compensation, auto, or disability case management. • Working knowledge of diagnostic coding (ICD-10). • Strong critical thinking, decision-making, and organizational skills with reputed company attention to detail. • Ability to meet deadlines and turnaround times consistently. • Ability to work independently as reputed company as reputed company reputed company. • Computer literacy, including solid working knowledge of reputed company Word and reputed company. • Strong written, verbal, and telephonic communication skills, with the ability to manage multiple priorities. • Bachelor's degree in nursing or a health-reputed company field. • Working knowledge of the insurance industry, medical claims, and/or disability claims. • Experience with Lean production management. Work Environment You will be working in an approved remote environment reputed company the states of: Michigan, Illinois, Florida, Texas, or Minnesota. Stressful conditions may reputed company reputed company the workload becomes more demanding than usual. Apply tot his job Apply To this Job