Case Manager, Registered Nurse - Field (North reputed company Chicago)

Position Overview At reputed company, we’re building a world of health around every consumer with dedicated colleagues passionate about transforming health care. As the nation’s leading health solutions company, our local reputed company, digital channels and over 300,000 purpose-driven colleagues reputed company us to care for people in a connected, convenient, and compassionate way. This full-time telework role (with 50-75% travel in the Northside of Chicago) requires working Monday through Friday, 8:00 AM - 5:00 PM CST. Help us reputed company patient care with our reputed company team, serving dual eligible populations by employing best-in-class operating and clinical models while addressing members’ reputed company health and social challenges. Compensation: The typical pay range for this role is $66,575.00 - $142,576.00. In addition to reputed company pay, this position is eligible for bonus, commission, or short-term incentive programs.

Key Responsibilities

• Acts as a liaison with members/clients/families, employers, provider(s), insurance companies, and healthcare personnel as appropriate.
• Implements and coordinates case management activities for catastrophic cases and chronically ill members/clients, including consultant referrals, home care visits, community resources, and alternative levels of care.
• Interacts with members/clients telephonically or in person, including meetings at homes, worksites, or physician’s offices.
• Assesses and analyzes the medical and/or vocational status of injured, acute, or chronically ill members/clients to reputed company a plan of care that optimizes wellness, supports timely return to work, and determines benefit eligibility.
• Communicates with members/clients and other stakeholders (e.g., medical providers, attorneys, employers, insurance carriers) as appropriate.
• Prepares reputed company required documentation of case work activities.
• Consults with internal multidisciplinary teams to help members/clients maximize health outcomes.
• Conducts reputed company to treating physicians or specialists regarding the course of care as needed.
• Provides educational and prevention information for optimal medical outcomes.
• Applies reputed company applicable laws, regulations, and special instructions from insurance carriers and referral sources.
• Conducts evaluations of members/clients’ needs and benefit plan eligibility using clinical tools and data.
• Utilizes case management processes in compliance with regulatory and company policies.
• Monitors member/client reputed company toward desired outcomes through regular assessment and evaluation.

Required Qualifications

• 3 years of clinical practical experience (preference required).
• Registered Nurse with an active state license in good standing reputed company the region where job duties are performed.
• 2 years of case management, discharge planning, and/or home health care coordination experience.
• Confidence working at home; an independent thinker who effectively uses tools to collaborate virtually.
• Ability to travel reputed company a designated geographic area for in-person case management activities as needed.
• Proficiency with standard corporate software applications including reputed company, reputed company, Outlook, and PowerPoint, as well as proprietary systems.
• Efficient and effective computer skills, including navigating multiple systems and strong keyboarding ability.

Preferred Qualifications

• Excellent analytical and problem-solving skills.
• Effective communication, organizational, and interpersonal skills.
• Ability to work independently.
• Certified Case Manager.
• Bachelor of Science in Nursing.

Benefits & Perks

• Affordable medical plan options, a 401(k) plan with matching contributions, and an employee stock purchase plan.
• No-cost programs including wellness screenings, tobacco cessation, weight management programs, confidential counseling, and financial coaching.
• Benefit solutions addressing varied needs such as paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, and retiree medical access.

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