What are the responsibilities and job description for the RN Case Manager position at CareNational?
Remote Registered Nurse (RN) - Case Manager
Position Type: Remote, Contract (3-4 months)
Pay Range: $40.00 / Hour
Schedule: M-F 8-5pm EST
Job Overview
Education and Experience:
Position Type: Remote, Contract (3-4 months)
Pay Range: $40.00 / Hour
Schedule: M-F 8-5pm EST
Job Overview
- Independently manages complex health care cases by multiple means such as phone, email, and video conferencing. Verifies eligibility, benefits, enrollment history, clinical history, and demographics. Assesses patient needs by gathering information from the member, family, provider, and other stakeholders to monitor and evaluate for medical appropriateness and quality of care. Educates members and assists them in removing barriers and with various treatment options.
- Facilitates and implements interventions based on agreed upon care treatment plan developed in collaboration with all participants in the members healthcare team. Coordinates services with community resources and support groups with members.
- Keeps up to date on and maintains appropriate documentation within Company and regulatory guidelines, policies, and practices.
- Performs other duties as assigned.
Education and Experience:
- RN OH license/Compact RN license required. Bachelor’s Degree preferred.
- 3 years as a Registered Nurse with a combination of clinical and case management experience, preferably in the health insurance industry.
- MCO/Health Plan experience required.
- Case Management and Home health care experience is a plus.
- Registered Nurse with current State of Ohio unrestricted license. Multiple state licensure preferred and may be required.
- Certified Case Manager (CCM) or other industry recognized certification preferred (required within 3 years of hire).
- Certification in Motivational Interviewing preferred.
- In depth knowledge of health insurance benefits, health plans, and industry trends, and the ability to apply knowledge to achieve positive outcomes.
- Strong knowledge of behavioral change techniques and health coaching (ex. readiness to change and motivational interviewing)
- Knowledge of, and the ability to apply fundamental concepts related to HIPAA compliance and related regulations.
- Knowledge of disease continuums, expected patient outcomes and community services available.
- Intermediate proficiency navigating windows and web-based systems and basic Microsoft Office skills.
Salary : $40
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