REMOTE Case Management RN

Location: Lexington, KY
Date Posted: 08-07-2018
Case Management RN – Managed Care
TeleCommute / Work From Home
* Multiple WORK-FROM-HOME Case Management Job Opportunities in throughout KENTUCKY! *
**Full-Time, Benefits Available CONTRACT opportunity, expected to last around 5 months! **
*** Must be licensed as an RN and reside in the State!  ***

Case Manager Job Summary:
  • The RN Case Manager will be responsible for the development of patient focused care delivery plans, along with coordinating, monitoring and evaluating the execution of the plans. 
  • The Case Manager will act as a patient advocate and navigator by facilitating continuity of patient care and care transitions with external healthcare organizations and facilities. 
  • The Case Manager will monitor the delivery of care by documenting care, identifying progress toward desired care outcomes and intervening to overcome deviations from the plan. 
  • They will assist staff in maintaining balance between the needs of the patient, physician(s) and contracted health plan.
  • The position will assist with data collection, health outcomes reporting and clinical audits.
  • The coordinator is also responsible for monitoring utilization and, if necessary, discuss utilization of services with provider and recommending alternative options when appropriate.
  • Develops and executes interdisciplinary care delivery plans by facilitating continuity of care and managing care transitions with external entities/physicians.
  • Monitors delivery of patient care by documenting care, verifying findings and reports, identifying progress or deviation from the plan, intervening to overcome deviation in the plan, and communicating regular updates to the appropriate caregivers.
  • This is primarily a WORK FROM HOME based, Telephonic case management position.
Case Manager Background: 
  • Valid, unrestricted state Registered Nurses (R.N.) license.
  • Prefer candidates that have a Bachelors of Science in Nursing, Social Work, or related field.
  • Required to obtain case management certification (CCM) within 3 years of hire.
  • Roughly 3 years of hospital, acute care clinical nursing experience.
  • Around 2-3 years’ experience in a Managed Care Organization (Health Plan/HMO/MSO/TPA/IPA/etc).
  • At least 1-2 years’ of case management experience with an MCO/ACO/TPA.
  • Experience working with Federal and State assistance programs (Medicare/Medicaid/etc).
  • Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts.
  • Possess planning, organizing, conflict resolution, negotiating and interpersonal skills.
  • Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
Erik Berg
443.470.8240 (CALL – TEXT – FAX)
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