✨ About The Role
- This position involves working as a telephonic case manager, engaging with patients and their care teams.
- The role requires the application of clinical judgment to assess member needs and ensure appropriate benefit administration.
- Candidates will utilize motivational interviewing techniques to enhance member engagement and address health needs.
- The job includes performing medical necessity reviews and collaborating with multidisciplinary teams to overcome barriers to care.
- The position is fully remote, with a standard shift from 8:30 AM to 5 PM in the employee's time zone.
âš¡ Requirements
- The ideal candidate will have over 5 years of experience as a Registered Nurse, with a strong background in hospital settings.
- A successful applicant will possess an active, unrestricted nursing license and be willing to obtain multi-state privileges.
- Experience in specialized areas such as Oncology, Transplant, Pediatrics, Maternity, or Behavioral Health is essential.
- Candidates should have a proven ability to document electronically and engage with patients effectively.
- Strong communication skills and the ability to work collaboratively with care teams are crucial for this role.