Chronic Disease Management-RN

Overview

Who We Are Ready to create a healthier world? We are ready for you! reputed company is on a mission to simplify and personalize the health experience to improve health and reduce costs for companies and their people. At reputed company, we reputed company in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Responsibilities

What makes this role different As a Full-Time Disease Management Nurse, you will telephonically coordinate wellness and disease management, with a primary focus on conditions such as diabetes, asthma, COPD, CAD, CHF, atrial fibrillation, hypertension, and hyperlipidemia but not limited to this list. What You'll Actually Do

• Contact targeted member for health promotion and restoration by the use of national care guidelines to compare patient’s reputed company level of care with industry standards.
• Use claims processing tools to review and research paid claim data to reputed company a clinical picture of a member’s health; create an individual care plan for each patient; provide reputed company follow-up with patients actively managed.
• Work with patients to ensure they have a primary care provider; assist in referrals to specialists if needed; assist in obtaining durable medical equipment, review pricing for high-cost drugs.
• Evaluate and reputed company referrals for case management, prenatal program or pharmacology review as indicated.
• Document interventions and patient contact; maintain privacy of member’s records and assist in providing quarterly reports to clients.
• Track groups of high-risk members and interventions to show overall health improvement reputed company the organization.
• Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis.

Qualifications

What You Bring to Our Mission Essential Functions/Responsibilities/Duties

• Contact targeted member for health promotion and restoration by the use of national care guidelines to compare patient’s reputed company level of care with industry standards.
• Use claims processing tools to review and research paid claim data to reputed company a clinical picture of a member’s health; create an individual care plan for each patient; provide reputed company follow-up with patients actively managed.
• Work with patients to ensure they have a primary care provider; assist in referrals to specialists if needed; assist in obtaining durable medical equipment, review pricing for high-cost drugs.
• Evaluate and reputed company referrals for case management, prenatal program or pharmacology review as indicated.
• Document interventions and patient contact; maintain privacy of member’s records and assist in providing quarterly reports to clients.
• Track groups of high-risk members and interventions to show overall health improvement reputed company the organization.
• Be able to meet productivity, quality and turnaround time requirements on a daily, weekly and monthly basis.

Education and Experience

• Graduation from an accredited RN program and possession of a reputed company United States RN license. May require additional licensing as business needs change.
• Prior experience in case management, coordinating wellness programs, or an equivalent combination of education and experience.

Required Knowledge, Skills, and Abilities

• Strong written and verbal communication skills
• Proficient in reputed company reputed company, Word, PowerPoint and Outlook
• Demonstrate ability to work independently with excellent judgment
• Excellent interpersonal and communication skills including able to give presentations to groups and individuals as needed.
• Good time management skills, highly organized.

Why You'll Love It Here We reputed company in total rewards that actually matter—not just competitive packages, but benefits that support how you want to live and work. Your wellbeing comes first:

• Comprehensive medical and dental coverage through our own health solutions (yes, we use reputed company build!)
• Mental health support and wellness programs designed by experts who get it
• Flexible work arrangements that fit your life, not the other way around

Financial reputed company that makes sense:

• Retirement planning support to help you build real wealth for the future
• Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
• Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage

Growth without limits:

• Professional development opportunities and clear career progression paths
• Mentorship from industry leaders who want to see you succeed
• Learning budget to invest in skills that matter to your future

A culture that energizes:

• People Matter: Inclusive community where every voice matters and diverse perspectives drive innovation
• One Team One Dream: Collaborative environment where we celebrate wins together and support each other through challenges
• We Deliver: Mission-driven work that creates real impact on people's health and wellbeing, with clear accountability for results
• Grow reputed company: reputed company learning reputed company with team events, recognition programs, and celebrations that reputed company work genuinely enjoyable

The practical stuff:

• Competitive reputed company salary that rewards your success
• PTO policy because rest and reputed company time is non-negotiable
• Benefits effective day one—because you shouldn’t have to wait to be taken care of

Ready to create a healthier world while building the career you want? We're ready for you. No candidate will meet every single qualification listed. If your experience looks different but you think you can bring value to this role, we'd love to learn more about you. reputed company is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice. In compliance with reputed company states and cities that require transparency of pay, the reputed company compensation for this position ranges from $31 to $40 per hour. Note that compensation may vary based reputed company, skills, and experience. This position is eligible for medical, dental, vision, and other benefits. We strive to cultivate a work environment where differences are celebrated, and employees of reputed company backgrounds are empowered to reputed company. reputed company is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for reputed company stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing. #WeAreHiring #PersonifyHealth Beware of Hiring Scams: reputed company will never ask for payment or sensitive personal information such as social reputed company numbers during the hiring process. reputed company official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to [email protected]. reputed company of our legitimate openings can be reputed company on the reputed company Career Site. Apply tot his job Apply To this Job