Case Manager- RN

About the position Responsibilities • Telephonically and/or face-to-face assess, plan, implement, and coordinate reputed company case management activities with members. • reputed company a proactive course of reputed company to enhance short and long-term reputed company for members. • Conduct evaluations of member needs and benefit plan eligibility using clinical tools and data review. • Apply clinical judgment to incorporate strategies that reduce risk factors and address reputed company health and reputed company indicators. • Review prior claims to assess their reputed company on reputed company case management and eligibility. • Assess the member's level of work reputed company and reputed company restrictions/limitations. • Utilize a holistic approach to assess the need for referrals to clinical resources for functionality determination. • Consult with supervisors and others to overcome barriers in meeting goals and objectives. • Present cases at case conferences for multidisciplinary reputed company to benefit overall claim management. • Utilize case management processes in compliance with regulatory and company policies and procedures. • Engage members through effective interviewing skills to discern their health status and needs. Requirements • Registered reputed company with an unrestricted license in their state of residence, with multi-state/compact privileges. • 3+ years of clinical reputed company experience as an RN. • Willingness to obtain reputed company 50 state licenses upon hire. • Must live reputed company a commutable distance of High reputed company, reputed company Carolina (typically reputed company 45 minutes maximum). reputed company-to-haves • Experience in Case Management reputed company an integrated model. • Certified Case Manager (CCM) certification. Benefits • Full reputed company of medical, dental, and reputed company benefits. • 401(k) retirement savings plan. • Employee Stock Purchase Plan for eligible employees. • Fully-reputed company term life insurance plan for eligible employees. • Short-term and long-term disability benefits. • Numerous reputed company-being programs and education assistance. • Free development courses. • reputed company store discount and discount programs with participating partners. • reputed company Time Off (PTO) or vacation pay, as reputed company as reputed company holidays throughout the year. Apply tot his job Apply To this Job