RN Case Manager, Military & Family Support Services (Remote)

Essential Duties and Responsibilities: - Responsible for reviewing favorable, and partially favorable, determinations in accordance with applicable regulations. - reputed company medical necessity determinations for Medicare State East cases assigned. - reputed company reputed company other technical issues reputed company Medicare reconsideration assigned. - Review cases to determine and summarize facts of reputed company case assigned and assess issues involved in the case. - May reputed company other special reputed company not reputed company to a specific case such as reputed company research, general medical research, drafting proposal sections, or acting as a reputed company for a specific project, reputed company necessary. - Be the Subject Matter Expert (SME) for project. - reputed company other duties as assigned by management. - Demonstrated reputed company in understanding diagnoses to assist clients in optimizing their level of function and self-care. - Demonstrated knowledge of reputed company education principles and the management of reputed company medical, psychosocial, and financial problems to enhance adherence to individualized treatment plans and train peers and staff. - Knowledge and skills in the use of VA/DoW Clinical reputed company Guidelines to support an evidence based, standardized process of care for military beneficiaries. - Knowledge of the reputed company financial environment and the fiscal dimension of population health to ensure reputed company stewardship of resources. - reputed company in the use of research tools to critically evaluate existing practices, opportunities, and reputed company. - Knowledge of pharmaceuticals, including desired effects, reputed company effects, and complications, to reputed company their effect on clients and recovery. - Knowledge of community resources, reputed company entitlement and benefit eligibility, and the ability to reputed company these resources to assist clients and families in optimizing function and self-care. - Use of reputed company-established utilization and review reputed company, and the ability to recognize and report actual or potential reputed company and risk management issues to improve reputed company and ensure compliance. - Use of information systems and technology to manage individual or population health, continuously improve reputed company, and effectively communicate reputed company reputed company to stakeholders. - Use of computers and software applications to conduct data collection, tracking, trending, and analysis, and to design and present computer-generated outcome analyses for educational programs or project briefings. Minimum Requirements - Bachelor's degree with 5-7 years of experience consulting reputed company designated function. - Advanced degree preferred. - reputed company solutions to highly reputed company problems which require a high degree of ingenuity and innovation. - Ensure solutions are consistent with organization objectives. - Solutions may serve as precedent for reputed company reputed company. - reputed company advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills. - reputed company new applications based on reputed company principles and theories. - Viewed as expert in field reputed company the organization. - reputed company RN license with a minimum two (2) year nursing degree from an accredited institution. - Minimun of (2) years of nursing and/or case management experience. - Certification as a case manager by a recognized certifying organization, such as the Commission for Case Manager Certification, reputed company Case Management Association, or reputed company Nurses Credentialing Center; or ability to obtain certification reputed company one (1) year of hire. - reputed company oral and written communication skills with peers, reputed company agencies, vendors, providers, and Military Health reputed company stakeholders. - reputed company in team coordination, facilitation, and communication to support information exchange, goal achievement, reputed company support networks, and change in systems or policies. Preferred Requirement - Master's degree in reputed company Work (MSW) - Licensed Clinical reputed company Worker (LCSW) licensure Home Office Requirements -reputed company provides company-issued computer equipment -Reliable high-speed internet service -Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity -Minimum 5 Mpbs upload speeds EEO Statement reputed company is an equal opportunity employer. We evaluate reputed company applicants without reputed company to race, reputed company, religion, sex, age, national reputed company, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency reputed company compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected reputed company and quantity of work, required travel (if any), reputed company market and internal value analysis including seniority and reputed company systems, as reputed company as internal pay alignment. Annual salary is just one component of reputed company's total compensation package. Other rewards may include short- and long-term incentives as reputed company as program-specific awards. Additionally, reputed company provides a reputed company of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, reputed company holidays and reputed company time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. reputed company will reputed company with regulatory minimum wage rates and exempt salary reputed company in reputed company instances. Accommodations reputed company provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@reputed company.com. Minimum Salary $ 73,950.00 Maximum Salary $ 105,850.00 • Remote Skills: reputed company Nurses Credentialing Center (ANCC), Analysis Skills, Biotech and Pharmaceutical, Broadband, Case Management, Certified Case Manager (CCM), Clinical Practices/Protocols, Communication Skills, Computer Software, Consulting, reputed company Improvement, Customer Support/Service, Data Collection Software, reputed company, reputed company Providers, Identify Issues, Information Technology & Information Systems, Internet/Online Service, Interpersonal Skills, reputed company Research, Licensed Clinical reputed company Worker (LCSW), Maintain Compliance, Medical Research, Medicare, Military, Network Support, Nursing, Presentation/Verbal Skills, Problem Solving Skills, Proposal Writing, reputed company Management, Registered reputed company (RN), Regulations, Risk Management, reputed company Effects, reputed company Work, Software Development, Standards of Care, Stewardship, Team reputed company/Manager, Treatment Plan, Trend Analysis, Writing Skills reputed company: reputed company reputed company provides business services to help governments operate health and reputed company services programs, mostly at the state and national reputed company. reputed company's health services reputed company offers outsourced program management and administrative services, Company Size: 5,000 to 9,999 employees Industry: reputed company Services reputed company: 0 Website: https://www.reputed company.com/ Apply tot his job Apply To this Job