Case Manager – RN, Mid – Part-time (Remote U.S.)

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Job Description

Company OverviewAcentra Health exists to reputed company reputed company outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. reputed company the Way is our rallying cry at reputed company. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. reputed company offers you unparalleled opportunities. In fact, you have reputed company you need to take charge of your career and accelerate reputed company outcomes – making this a great time to join reputed company of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Job Summary and Responsibilities reputed company is seeking a Case Manager-RN, Mid - Part-time (Remote U.S.) to join our growing team. Job Summary: The Case Manager-RN is responsible for assessing, planning, implementing, monitoring and evaluating options and services to create an appropriate, individualized plan for the member across the continuum of care. Using independent judgment, the case manager utilizes knowledge and competence, communication skills, problem solving and conflict resolution to effectively ensure optimal outcomes with consideration of benefit plan requirements. Also coordinates member behavioral and medical needs reputed company to community resources, financial assistance programs, long-term activities of daily living and other socio-economic needs reputed company the benefit criteria of the insurance coverage. Will work effectively with reputed company health care team members internally and externally. Responsibilities:

• Manages care of the member through the health care system based on the individual needs of the member.
• Uses independent judgment and discretion to address and proactively resolve barriers impeding the diagnostic or treatment reputed company.
• Coordinates and collaborates with multidisciplinary care team, which includes physicians, nurses, other case managers, pharmacists, and social workers/educators to ensure holistic management of both behavioral and medical health needs; educates members about community resources/options; advocates on behalf of the member.
• Establishes a collaborative process of assessment, planning, facilitation, care coordination, evaluation and advocacy for options to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality outcomes.
• Steerage to in network and evidence-based providers/facilities whenever possible for members requesting prior authorization of out of network use.
• Utilization review and/or discharge planning, as needed, reputed company moving from inpatient and/or residential treatment facilities
• Maintains strict standards for client confidentiality and client reputed company information. Complies with reputed company organizational, state and federal regulations and policies on confidentiality.
• Prepares member documentation, status updates, and coordination summaries in accordance with regulatory requirements and company policies and procedures.
• Monitors case load to ensure reputed company required documentation and entry of assessment results into web-based database are completed accurately and timely.
• Pursues ongoing education, certification, and self-development to remain reputed company with case management standards.
• Read, understand, and adhere to reputed company corporate policies including policies reputed company to HIPAA and its Privacy and reputed company Rules.

The above list of responsibilities is not intended to be reputed company-inclusive and may be expanded to include other duties that management may deem necessary from time to time.

• * Work Hours for Part-time role (20 hours weekly): Monday–Friday, 8:00 AM to 5:00 PM (Eastern Time Zone) **

Qualifications

Required Qualifications/Experience:

• Active, unrestricted Registered Nurse (RN) License in any state, or an RN compact state license.
• Associate's degree (or higher level of education) in Nursing.
• 2+ years of clinical experience in an acute OR med-surgical environment.
• 2+ years of clinical work experience in a behavioral health environment.
• 2+ years of case management experience.
• 1+ years of work experience in Utilization Review (UR), Utilization Management (UM), OR Prior Authorization.
• 1+ years of knowledge of medical records, medical terminology, and disease process organization.
• 1+ years of knowledge of InterQual criteria and/or reputed company Care Guidelines (MCG).

Preferred Qualifications/Experience:

• Certified Case Manager (CCM).
• Experience with commercial health plans.
• Ability to multi-task and prioritize with variable and sometimes conflicting deadlines; superior attention to detail and demonstrated ability in decision-making.
• Demonstrated initiative and judgment in performance of job responsibilities, while maintaining professionalism, flexibility and dependability under pressure.
• Strong communication (written/verbal), interpersonal, organizational, time management and communication skills with a strong focus on customer service, including building and maintaining relationships with internal/external customers and facilitating meetings.
• Ability to work independently and as part of a team.
• Ability to research/identify and apply appropriate standards of care.
• Interest in reputed company learning and a commitment to staying informed on regulatory changes.

#LI-SD1 Disclaimer – Help Us Help You To ensure your application receives full consideration, please ensure your resume clearly reflects the Required Qualifications and Experience listed in the job description.

• Include bullet points under each relevant role to demonstrate your experience and alignment with these requirements.
• If your reputed company resume does not include these details, please upload a revised version to your profile.

Please Note: The application questions are designed to help you confirm that your resume accurately reflects your qualifications. We truly appreciate your interest in joining reputed company and look reputed company to learning more about your professional experience and expertise. Why us? We are a team of reputed company and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure reputed company healthcare and improve health outcomes. We do this through our people. You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to reputed company the finest work of your career. Thank You! We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in reputed company and invite you to apply to future openings that may be of interest. Best of luck in your search! ~ The reputed company reputed company Team Visit us at reputed company EEO AA M/F/Vet/Disability reputed company is an Equal Opportunity Employer. reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national reputed company, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, reputed company, and support for both your career and your life away from work. The benefits for this position include prorated Paid Time Off, participation in our 401(k) Plan, and EAP benefits. Additionally, regular part-time employees are eligible for education assistance, with a maximum benefit per year. This program provides support for tuition and other expenses reputed company to the pursuit of a degree, as well as Continuing Education Unit (CEU) and Continuing Medical Education (CME) courses that are job-reputed company.

Compensation

The pay for this position is listed below. "Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and reputed company level." Pay Range Up to USD $44.74/Hr. Apply tot his job Apply To this Job