Case Manager, RN

Role Overview

• Responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members from our Federal Plans
• Evaluate the medical needs of the member to facilitate and promote the member’s overall wellness
• Develop a proactive course of action to address issues presented to enhance the member's short and long term outcomes
• Apply data driven methods of identification of members for individualized case management programs
• Conduct comprehensive clinical assessments
• Evaluate needs and develop flexible approaches based on member needs, benefit plans or external programs/services
• Advocate for patients to the full extent of existing health care coverage
• Promote quality, cost effective outcomes, and suggest improvements to program/operational efficiency
• Identify and escalate quality of care issues through established channels
• Provide a very high level of customer service
• Utilize assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change
• Utilize influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes

Requirements

• Must have active, current and unrestricted RN licensure in state of residence and have the ability to be licensed in all non-compact states
• Must be willing and able to work Monday through Friday, 8 hour shift between 7am to 5pm Arizona time
• Must live in either PST, MST, or Arizona Time zones
• 3+ years of clinical practice experience required
• 1+ years of experience utilizing MS Office suites
• Case management experience preferred
• Case Manager Certification

Benefits

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families