Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Competitive Salary up to $90,000
- Opportunity for career advancement and growth within the organization
- Work remotely anywhere within the continental U.S.
- Supportive and collaborative work environment
- Chance to make a positive impact on patient care and health outcomes

What to Expect (Job Responsibilities):
- Independently collaborates effectively with Interdisciplinary care team (ICT) to establish an individualized transition plan for members
- Serves as the clinical liaison with hospital, clinical, and administrative staff as well as performs a review for clinical authorizations for inpatient care utilizing evidenced-based criteria within our documentation system
- Conducts a transition discharge assessment onsite and/or telephonically to identify member needs at the time of transition to a lower level of care
- Enters timely and accurate documentation into designated care management applications to comply with documentation requirements and achieve audit scores of 90% or better on a monthly basis
- Refers cases to UM Medical Director as appropriate for review for cases not meeting medical necessity criteria or for complex case situations

What is Required (Qualifications):
- Bachelor’s degree in Nursing and/or, Associate’s degree in Nursing combined with 4+ years of experience above the required years of experience
- Current, unrestricted RN license required, specific to the state of employment
- Case Management Certification (CCM) or ability to obtain CCM within 12 months after the first year of employment
- 4+ years of diverse clinical experience in caring for the acutely ill patients with multiple disease conditions
- Knowledgeable in Microsoft Office applications including Outlook, Word, and Excel

How to Stand Out (Preferred Qualifications):
- 3+ years of managed care and/ or case management experience
- Experience working with psychiatric and geriatric patient populations
- Bilingual (English/Spanish) language proficiency
- Proven ability to problem solve and identify community resources
- Proven ability to utilize critical thinking skills, nursing judgment, and decision-making skills

#HealthcareServices #CaseManagement #CareerOpportunity #CompetitivePay #RemoteWork

We prioritize candidate privacy and champion equal-opportunity employment. Central to our mission is our partnership with companies that share this commitment. We aim to foster a fair, transparent, and secure hiring environment for all. If you encounter any employer not adhering to these principles, please bring it to our attention immediately.
We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.