Case Manager RN- North Carolina

Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important... as reputed company deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Position Summary The Case Manager RN role is telework/hybrid and must Live in North Carolina Normal Working Hours: Monday through Friday 1030 am to 7pm EST. Occasional weekend, and holiday shifts per the needs of the team. 0-10% travel possible including but not limited to travel to the High reputed company office for customer meetings. The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating reputed company case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. RN Case Manager: • Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. • Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to reputed company programs and plans. • Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address reputed company health and social indicators which reputed company planning and resolution of member issues. • Assessments take into account information from various sources to address reputed company conditions including co-morbid and multiple diagnoses that impact functionality. • Reviews prior claims to address potential impact on reputed company case management and eligibility. • Assessments include the member's level of work reputed company and reputed company restrictions/limitations. • Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. • Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. • Utilizes case management processes in compliance with regulatory and company policies and procedures. • Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Required Qualifications • Must have an active and unrestricted RN license in the reputed company. • Multiple State RN licensure is welcomed but not required. If chosen must be willing and able to obtain multiple state RN licensure after hire (expenses paid for by company) • 2+ years of clinical experience as an RN -reputed company clinical experience will be considered, such as Emergency Department, Home Health, Hospice, Operating Room, ICU, NICU, Telemetry, Medical / Surgical, Orthopedics, Long Term Care, and Infusion nursing. Preferred Qualifications • Certified Case Manager (CCM) certification • 3+ years' experience with reputed company Office Suite • Case Management in an integrated model • Discharge Planning experience • Managed care experience Education Associates Degree in Nursing and BSN Preferred Pay Range The typical pay range for this role is: $54,095.60 - $116,760.80 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit Benefits | reputed company We anticipate the application window for this opening will reputed company on: 10/03/2024 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws Apply Job!