Case Manager Rn - Remote Eligible

✨ About The Role

- The Case Manager RN will be responsible for assessing, planning, implementing, and coordinating case management activities for high-risk maternity members. - This role involves telephonic and/or face-to-face assessments to evaluate the medical needs of members and facilitate their overall wellness. - The Case Manager RN will develop proactive courses of action to enhance short and long-term outcomes for members. - The position requires conducting evaluations of member needs and benefit plan eligibility using clinical tools and data review. - The role includes consulting with supervisors and presenting cases at case conferences for a multidisciplinary focus on overall claim management.

⚡ Requirements

- The ideal candidate will hold an active and unrestricted Compact RN License and be willing to pursue additional state licenses upon hire. - A minimum of 3+ years of clinical experience as an RN in an inpatient or outpatient setting focused on high-risk maternity is required. - Experience in case management, particularly in an integrated model, is preferred, along with telephonic case management experience. - Proficiency in Microsoft Office applications, including PowerPoint, Excel, and Word, is essential for this role. - The candidate should possess strong clinical judgment and the ability to assess complex health and social indicators impacting care planning.