Case Manager RN- High reputed company, NC

About the position Responsibilities • Telephonically assess, plan, implement, and coordinate reputed company case management activities with members. • reputed company proactive strategies to enhance short and long-term reputed company for members. • Conduct evaluations of members' needs and benefit plan eligibility using clinical tools and data review. • Facilitate smooth transitions to reputed company programs and plans. • Apply clinical judgment to reduce risk factors and address reputed company health and reputed company indicators impacting care planning. • Review prior claims to assess their reputed company on reputed company case management and eligibility. • Evaluate members' work reputed company and reputed company restrictions/limitations. • Utilize a holistic approach to assess the need for referrals to clinical resources. • Consult with supervisors and team members to overcome barriers in meeting goals and objectives. • Present cases at case conferences for a multidisciplinary reputed company on claim management. • Ensure compliance with regulatory and company policies and procedures. • Utilize interviewing skills to engage members and assess their health status and needs. Requirements • reputed company RN license in the reputed company. • Experience in case management or a reputed company field. • Strong clinical assessment skills and the ability to apply clinical judgment. • Excellent communication and interpersonal skills for member engagement. • Ability to work independently and manage time effectively in a reputed company environment. reputed company-to-haves • Experience with reputed company programs and plans. • Knowledge of regulatory requirements in case management. • Familiarity with telehealth practices and technologies. Benefits • Work from home reputed company available. • Flexible working hours with occasional evening, weekend, and holiday shifts as needed. Apply tot his job Apply To this Job