RN Case Manager - Remote

Overview

As a registered nurse with an Illinois nursing license, you will work remotely to enhance the quality of member management, maximize both satisfaction and cost effectiveness, and assist in navigating the health care system as a collaborative health partner in their health care team.

In Short

• Pulling, sorting, and analyzing data to determine member eligibility for the Population Health management Program.
• Coordinating and providing care that is timely, effective, equitable, safe, and member-centric.
• Managing case assignments which includes outreach, documentation, monitoring for case progression, and case closure.
• Meeting reporting and documentation standards while engaging in collaborative meetings.
• Assisting members in reaching wellness and health-autonomy.
• Helping members make informed decisions by educating them on navigation through the HMO.
• Supporting operational aspects of the division to meet customer requirements.
• Maintaining confidentiality related to all computer programs and medical records.
• Participation in QM/UM Committee Meetings.
• Responsible for continued professional growth and education.

Requirements

• Current IL Registered Nurse License.
• Minimum of five years of experience in a variety of health care settings.
• Highly experienced in Case Management and Chronic Condition Management.
• Knowledge of utilization review, quality improvement, managed care, and/or community health.
• Previous remote and/or telephonic work experience.
• Excellent clinical judgment and communication skills.
• Strong organizational, problem solving, and time management skills.
• Ability to work independently and remotely.
• Must possess software knowledge including MS Word, Excel, Access, etc.
• A high speed/secured home internet connection.

Benefits

• Remote work flexibility.
• Supportive work environment.
• Opportunity for professional growth.
• Access to necessary equipment for remote work.