Care Manager RN - Remote

Overview

The Care Manager RN is responsible for implementing effective utilization management strategies, monitoring healthcare service delivery, and enhancing member satisfaction through proactive education and interventions.

In Short

• Implement care management review processes.
• Ensure compliance with state and federal laws.
• Promote quality and efficiency in care management services.
• Educate providers and members on healthcare options.
• Analyze data to improve care management services.
• Develop positive relationships with customers.
• Identify opportunities for referral to Health Coaching.
• Utilize outcomes data for ongoing service improvement.
• Function within ethical principles and privacy regulations.
• Perform other duties as assigned.

Requirements

• Current RN state licensure required.
• 3 years of related clinical experience required.
• Experience in utilization management preferred.
• Strong analytical and organizational skills.
• Excellent written and verbal communication skills.
• Ability to multi-task in a fast-paced environment.
• Knowledge of regulatory guidelines and medical policies.
• Certification in utilization management preferred.
• Enthusiastic and innovative team player.
• Ability to prioritize work demands effectively.

Benefits

• Competitive salary range.
• Comprehensive health benefits.
• Opportunities for professional development.
• Supportive work environment.
• Flexible work arrangements.
• Access to wellness programs.
• Employee assistance programs.
• Retirement savings plan.
• Paid time off and holidays.
• Employee discounts on services.