Case Manager RN- Afternoon shift
About the position
Responsibilities
• Telephonically and/or face-to-face assess, plan, implement, and coordinate all case management activities with members.
• Develop proactive courses of action to enhance short and long-term outcomes for members.
• Conduct evaluations of member needs and benefit plan eligibility using clinical tools and data review.
• Apply clinical judgment to reduce risk factors and address complex health and social indicators.
• Review prior claims to assess their impact on current case management and eligibility.
• Assess members' work capacity and related restrictions/limitations.
• Utilize a holistic approach to determine the need for referrals to clinical resources.
• Consult with supervisors and present cases at case conferences for multidisciplinary focus.
• Utilize case management processes in compliance with regulatory and company policies.
• Engage members through effective interviewing skills to discern their health status and needs.
Requirements
• Active current and unrestricted RN licensure in the state of residence.
• Willingness to obtain multiple state RN licensure after hire (expenses paid by company).
• 2+ years as an RN with med/surge experience, Emergency Department, and Telemetry.
• Willingness to work Monday - Friday 9:00 am - 5:30 pm.
• Willingness to work late shift once per quarter until 9 pm.
• 1+ year experience with Microsoft Office including PowerPoint, Excel, and Word.
Nice-to-haves
• 2+ years of Case Management experience.
• Strong telephonic communication skills.
• Certified Case Manager (CCM) certification.
Benefits
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with partners.
• Paid Time Off (PTO) and paid holidays.
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