Position title
Nurse Case Manager (REMOTE POSITION)
Description

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Gig overview

"Telephonic" Nurse Case Manager will be responsible for performing care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning.

Gig description

Primary duties may include, but are not limited to:

  • Ensures member access to services appropriate to their health needs.
  • Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment.
  • Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements.
  • Coordinates internal and external resources to meet identified needs.
  • Monitors and evaluates effectiveness of the care management plan and modifies as necessary.
  • Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans.
  • Negotiates rates of reimbursement, as applicable.
  • Assists in problem solving with providers, claims or service issues.

Qualifications

Nurse Case Mgr I

  • Requires a BA/BS in a health related field; 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required.
  • Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.
  • Minimum 2 years experience in acute care setting.
  • Certification as a Case Manager is preferred.
  • Managed Care experience preferred.
  • Multi-state licensure is required if this individual is providing services in multiple states.

Nurse Case Mgr II

  • Requires a BA/BS in a health related field; 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
  • Current, unrestricted RN license in applicable state(s) required.Case Management experience preferred.
  • Minimum 2 years "telephonic" Case Management experience with a Managed Care Company.
  • Minimum 2 years experience in acute care setting.
  • Certification as a Case Manager is preferred.
  • Managed Care experience preferred.
  • Multi-state licensure is required if this individual is providing services in multiple states.

Technical skills:

  • Ability to talk and type at the same time.
  • Demonstrate critical thinking skills when interacting with members.
  • Experience with (Microsoft Office) and/or ability to learn new computer programs/systems/software quickly.
  • Ability to manage, review and respond to emails/instant messages in a timely fashion.

 

Shifts: Monday - Friday, 9:30am - 6pm EST

Location: REMOTE

Additional Details: This position requires an on-line pre-employment skills assessment

Job Benefits

Health, dental, vision, life, disability, retirement, and more is available

Eligible CareerGig freelancers get access to affordable guaranteed-issue health, dental, vision, life, and disability insurance, as well as other benefits such as retirement and more.

What's more, CareerGig contributes a portion of our fees towards your benefits. You can learn more about CareerGig benefits here.

Contacts

To apply, please do the following:

  1. Register for CareerGig and provide us your honest opinion. We thrive on transparency and radical candor here at CareerGig. Tell us how you would improve the CareerGig experience.

  2. Apply for this opportunity by signing up through the CareerGig platform and applying there. Search for "Nurse Case Manager" and you'll see the position. It’s free to join the CareerGig Platform - click here.

CareerGig (Digics, Inc.) is an equal opportunity employer.

Employment Type
Full-time
Job Location
Remote work possible
Valid through
March 28, 2021
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Position: Nurse Case Manager (REMOTE POSITION)

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