Complex Case Manager RN - Remote

Overview

The Complex Case Manager RN is responsible for managing a panel of members with varying health needs, utilizing clinical judgment and data analytics to develop appropriate care plans and interventions.

In Short

• Ownership of a specified panel of members' health management.
• Utilization of data and clinical judgment for interventions.
• Management of an active case load with outreach to members.
• Development of care plans to improve health outcomes.
• Ensuring compliance with regulatory requirements.
• Collaboration with a multi-disciplinary team.
• Monitoring and maintaining quality outcomes.
• Required RN licensure and relevant experience.
• Skills in negotiation and influencing others.
• Ability to work autonomously and handle multiple priorities.

Requirements

• High School Diploma/GED required; Bachelor's Degree in Nursing preferred.
• 7 years of experience in clinical and case management.
• Certification in Case Management preferred.
• Proficiency in MS Excel and strong analytical skills.
• Excellent interpersonal and organizational skills.
• Ability to work in a fast-paced environment.
• Current RN licensure in PA or multi-state licensure.
• Experience with diverse populations and cultural competency.
• Understanding of healthcare costs and delivery systems.
• Self-directed with the ability to work with moderate autonomy.

Benefits

• Competitive salary range.
• Comprehensive health benefits.
• Supportive work environment.
• Opportunities for professional development.
• Flexible working conditions.
• Engagement in a multi-disciplinary team.
• Access to various resources for member support.
• Commitment to diversity and inclusion.
• Work-life balance initiatives.
• Employee wellness programs.