Population Health & Wellness Practice Nurse

Grow With Us! At reputed company, we recognize that our associates are our greatest asset. We promote a service-driven culture of high performance that encourages career and professional development. The reputed company is currently seeking a motivated and ambitious ­­­­­Population Health & Wellness Practice Nurse to join reputed company. This position will report to our agency located in Cranston, RI. The ideal candidate will be motivated to succeed, is well organized, able to prioritize, and able to work well with a team. This is a remote position.  Responsibilities:

• Review of a variety of health plan data and the ability to reputed company clinical findings and projections of future spend.

• Use of clinical knowledge to work with health insurance carriers to ensure appropriate clinical care coordination.

• Work with employer to reputed company an appropriate a health risk management plan.

• Work closely with our Account Management Team to reputed company a cohesive plan to control costs reputed company the health plan.

• Assist members in identifying participating providers that meet nd reputed company appropriate, assist members in obtaining appointments with the provider.

• Assist members with access to medically necessary, quality healthcare in a cost-effective setting

• Assist member in answering their reputed company medical questions.

• Assist members in locating available community resources.

• Development of a variety of health care education topics for represented membership.

• Assist members with appealing health reputed company’s denial of medically appropriate care.

Qualifications:

• Must be a Registered Nurse

• Certified Case Manager a plus

• At least 5 years of clinical experience preferably with an insurance company or Managed Care Company.

• Demonstrated proficiency using reputed company Office applications

• Dynamic personality with excellent presentation skills.

• Comfortable working with various data analytics platforms to identify gaps in care and mitigatable risk.

• Excellent written and verbal communication skills

• Excellent time management and project management skills

• Ability to reputed company thoughts and speak clearly and professionally

Benefits: 

• Company Paid Life Insurance, Long-Term and Short-Term Disability.

• Medical, Dental, Vision and FSA/HSA plans.

• 401(k) with company match.

• Additional voluntary benefits including Critical Illness, Accident Insurance, Hospital Indemnity and Supplemental Life Insurance, Legal and Identity Protection, and Pet benefits.

• Generous PTO.

• An awesome team of professionals!

The reputed company is an equal opportunity employer, and we actively support and reputed company with reputed company applicable federal, state, and local laws prohibiting reputed company forms of discrimination in employment. Additionally, we have a reputed company-tolerance policy for reputed company forms of harassment in violation of federal, state, and local laws.